ABSTRACT
Background: Currently; no data are available on the prevalence of red blood cell (RBC) antibody formation amongst Kenyan patients with multiple transfusion needs; such as patients with sickle cell disease (SCD) or haematological malignancies (HM) and solid (SM) malignancies.Objectives: We determined the prevalence and specificities of RBC alloantibodies and autoantibodies in two patient groups with recurrent transfusion demands at Kenyatta National Hospital; Nairobi; Kenya. Method: Between February and August 2014; 300 samples from SCD; HM and SM patients were collected and screened for alloantibodies. Samples from 51 healthy blood donors were screened for irregular antibodies and phenotyped.Results: Amongst the 228 patients with viable samples (SCD; n = 137; HM; n = 48; SM; n = 43); the median transfusion frequency was two to three events per group; 38 (16.7%) were RBC immunised and 32 (14.0%) had a positive direct antiglobulin test. We identified specific alloantibodies in six patients (2.6%). Four of these six were SCD patients (2.9%) who had specific RBC alloantibodies (anti-Cw; anti-M; anti-Cob; anti-S); amongst HM patients one had anti-K and one had anti-Lea. RBC autoantibody prevalence was 3.1% (7/228). Amongst the healthy blood donors; the Ror; ccD.ee and R2r; ccD.Ee phenotypes accounted for 82% of the Rhesus phenotypes and all were Kell negative.Conclusion: The numbers of transfusions and the rates of RBC alloantibodies are low and the most important RBC alloantibody-inducing blood group antigens are relatively homogeneously distributed in this population. A general change in the Kenyatta National Hospital pre-transfusion test regimen is thus not necessary. The current transfusion practice should be reconsidered if transfusion frequencies increase in the future