Red cell alloimmunization in repeatedly transfused thalassemia major patients

ABSTRACT

Thalassemia major patients managed by regular transfusion regimen may develop anti-red cell alloimmunization. If the alloantibodies are hemolyzing in nature, transfusion reaction may occur, and provision of blood thereafter requires matching of the relevant blood group in addition to "ABO" and Rh 'D' matching. We investigated 75 cases of multiply transfused thalassemia major patients for development of alloantibodies against red cells by indirect antiglobulin test, using 3-red cell panel, and when required 11-red cell panel. Anti-red cell alloantibodies were detected in 17 [22.7%] patients. Anti-Kp[a] antibodies were the commonest, followed by Anti-e, anti-E and anti-K antibodies, respectively. Anti-k, -C[W], -Fy[b], -Kp[b], -Rh 'D' and -c were detected in one patient each. It is concluded that in multiply transfused patients, alloantibodies develop in a significant number of patients. The hemolyzing nature of antibodies should be determined in patients who develop these antibodies, and transfusion should be arranged accordingly