Review

Blood Transfusion - 1 2019 (January-February)

Red blood cell alloimmunisation in transfusion-dependent thalassaemia: a systematic review

Authors

Key words: thalassaemia, alloimmunisation, red blood cells, transfusion, complications
Publication Date: 2019-01-08

Abstract

Background. Chronic red blood cell transfusion is the first-line treatment for severe forms of thalassaemia. This therapy is, however, hampered by a number of adverse effects, including red blood cell alloimmunisation. The aim of this systematic review was to collect the current literature data on erythrocyte alloimmunisation.
Materials and methods. We performed a systematic search of the literature which identified 41 cohort studies involving 9,256 patients.
Results. The prevalence of erythrocyte alloimmunisation was 11.4% (95% CI: 9.3-13.9%) with a higher rate of alloimmunisation against antigens of the Rh (52.4%) and Kell (25.6%) systems. Overall, alloantibodies against antigens belonging to the Rh and Kell systems accounted for 78% of the cases. A higher prevalence of red blood cell alloimmunisation was found in patients with thalassaemia intermedia compared to that among patients with thalassaemia major (15.5 vs 12.8%).
Discussion. Matching transfusion-dependent thalassaemia patients and red blood cell units for Rh and Kell antigens should be able to reduce the risk of red blood cell alloimmunisation by about 80%.
 

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Authors

Massimo Franchini - Italian National Blood Centre, National Institute of Health, Rome; Department of Haematology and Transfusion Medicine, "Carlo Poma" Hospital, Mantua

Gian Luca Forni - Centre for Microcythemia and Congenital Anaemia, "Galliera" Hospital, Genoa

Giuseppe Marano - Italian National Blood Centre, National Institute of Health, Rome

Mario Cruciani - Italian National Blood Centre, National Institute of Health, Rome; Infection Control Committee and Antibiotic Stewardship Programme, AULSS9 "Scaligera", Verona

Carlo Mengoli - Italian National Blood Centre, National Institute of Health, Rome

Valeria Pinto - Centre for Microcythemia and Congenital Anaemia, "Galliera" Hospital, Genoa

Lucia De Franceschi - Department of Medicine, University of Verona and aoui-Verona, Policlinico "G.B. Rossi", Verona

Donatella Venturelli - Department of Transfusion Medicine, University Hospital of Modena, Modena

Maddalena Casale - Department of Women, Children and General and Specialised Surgery, "Luigi Vanvitelli" University of Campania, Naple

Martina Amerini - Italian National Blood Centre, National Institute of Health, Rome; Italian Foundation for Research on Anaemia (FORANEMIA) and Haemoglobinopathies, Genoa

Martina Capuzzo - Mother-Infant Department, University of Modena and Reggio Emilia, Modena

Giuliano Grazzini - Italian National Blood Centre, National Institute of Health, Rome; Italian Foundation for Research on Anaemia (FORANEMIA) and Haemoglobinopathies, Genoa

Francesca Masiello - Italian National Blood Centre, National Institute of Health, Rome

Ilaria Pati - Italian National Blood Centre, National Institute of Health, Rome

Eva Veropalumbo - Italian National Blood Centre, National Institute of Health, Rome

Stefania Vaglio - Italian National Blood Centre, National Institute of Health, Rome; Department of Clinical and Molecular Medicine, "Sapienza" University of Rome, Rome, Italy

Simonetta Pupella - Italian National Blood Centre, National Institute of Health, Rome

Giancarlo M. Liumbruno - Italian National Blood Centre, National Institute of Health, Rome

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