Phenotype Matching of Regular Donors with Transfusion-Dependent Thalassemia Patients; the Role of Alloantibody and Blood Group Profiling.
Source: PubMed, NCBI / U.S. National Library of Medicine
Regular blood transfusion causes many problems in thalassemia patients, particularly alloimmunization against donor red blood cell (RBC) antigens. This study investigated the prevalence of alloantibodies in transfusion-dependent thalassemia (TDT) patients and RBC phenotype in both patients and regular donors aiming to develop a specialized blood pool for these patients.A total of 281 TDT patients, who received blood once every 2, 3, or 4 weeks, were enrolled. Antibody screening and identification tests were performed to check the prevalence of alloantibodies. The RBCs of patients and 400 regular blood donors were also collected to determine the phenotype of major blood groups. Among 281 thalassemia patients (49% female, average age of first blood transfusion: 17 months), the results of antibody identification showed that 19% had alloantibodies (7% with one alloantibody, 10% with two alloantibodies, and 2% with three alloantibodies).The frequency of alloantibodies against C, c, E, e, K, and D antigens were 1.8% (95% CI: 0.4-3.6), 0.4% (95% CI: 0-1.1), 12.8% (95% CI: 8.9-17.1), 1.1% (95% CI: 0-2.5, 16.7% (95% CI: 12.5-21), and 1.1% (95% CI: 0-2.5), respectively. Among 400 donors, 74% were C-positive; 71% c-positive; 22% E-positive, 98.5% e-positive, and 2.5% K-positive. Phenotype-matching data showed that 71% of TDT patients had one matched regular donor, and 29% of the patients had 2-4 suitable donors. RBC extended-phenotyping is necessary to create a specialized blood bank of
Abstract
Regular blood transfusion causes many problems in thalassemia patients, particularly alloimmunization against donor red blood cell (RBC) antigens. This study investigated the prevalence of alloantibodies in transfusion-dependent thalassemia (TDT) patients and RBC phenotype in both patients and regular donors aiming to develop a specialized blood pool for these patients.A total of 281 TDT patients, who received blood once every 2, 3, or 4 weeks, were enrolled. Antibody screening and identification tests were performed to check the prevalence of alloantibodies. The RBCs of patients and 400 regular blood donors were also collected to determine the phenotype of major blood groups. Among 281 thalassemia patients (49% female, average age of first blood transfusion: 17 months), the results of antibody identification showed that 19% had alloantibodies (7% with one alloantibody, 10% with two alloantibodies, and 2% with three alloantibodies).The frequency of alloantibodies against C, c, E, e, K, and D antigens were 1.8% (95% CI: 0.4-3.6), 0.4% (95% CI: 0-1.1), 12.8% (95% CI: 8.9-17.1), 1.1% (95% CI: 0-2.5, 16.7% (95% CI: 12.5-21), and 1.1% (95% CI: 0-2.5), respectively. Among 400 donors, 74% were C-positive; 71% c-positive; 22% E-positive, 98.5% e-positive, and 2.5% K-positive. Phenotype-matching data showed that 71% of TDT patients had one matched regular donor, and 29% of the patients had 2-4 suitable donors. RBC extended-phenotyping is necessary to create a specialized blood bank of matched packed RBCs from regular donors to decrease alloimmunization among TDT patients. Especially, extended matching for RH C/c, E/e, and Kell antigens should be incorporated in routine pre-transfusion testing protocols. protocols. The online version contains supplementary material available at 10.1007/s12288-025-02168-8.