RED CELL ALLOIMMUNIZATION IN MULTIPLY TRANSFUSED THALASSAEMIA PATIENTS:A STUDY ON 300 CASES IN A TERTIARY CARE HOSPITAL OF NORTH EAST INDIA.

Dr Samim Sultana Hoque; Dr Deep Jyoti Kalita; Dr Tirtha Chaliha; Dr Tarali Pathak

Volume : VII, Issue : XII, December - 2017

RED CELL ALLOIMMUNIZATION IN MULTIPLY TRANSFUSED THALASSAEMIA PATIENTS:A STUDY ON 300 CASES IN A TERTIARY CARE HOSPITAL OF NORTH EAST INDIA.

Dr Samim Sultana Hoque, Dr Deep Jyoti Kalita, Dr Tirtha Chaliha, Dr Tarali Pathak

Abstract :

Introduction & Background:Alloimmunization i.e. development of alloantibody against the foreign RBC is one of the important complications of blood transfusions in multiply transfused thalassaemia patients.We studied the frequency of red blood cell(RBC) alloimmunization among thalassemia patients who received regular transfusions at our center and analyzed the factors,which may be responsible for development of these antibodies.Patient/Material and methods:The study was carried out on 300 thalassemia patients in the age ranging from 2 to 40 years who were dependent on transfusion and had a history of blood transfusion at least once in every month. The patient’s age, sex, ABO and Rh blood group, history of splenectomy, type of thalassemia,age of first transfusion and number of total blood transfusion were recorded.Alloantibody screening and identification was done using three cell and 11 cell panel respectively.Results: Sixteen patients out of total 300 patients(5.33%) developed alloantibodies and 3 patients(1%) developed autoantibodies.A total of 19 alloantibodies were identified in patient population.The most common alloantibody was Rh–related (78.92%; 15 of 19), comprising anti–c (42.1%; 8 of 19),anti–E(26.3%; 5 of 19),anti–C & D (5.26% each; 1 of 19), followed by anti–Kell (10.5%; 2 of 19)comprising of anti–K,anti–Kidd (comprising of anti–Jka 5.26%; 1 of 19 and anti–Jkb 5.26%:1 of 19).Conclusion : Alloimmunization was detected in 5.33% of multitransfused thalassemia patients. Rh and Kell blood group system antibodies accounted for more than 80% of alloantibodies.This study re–emphasizes the need for RBC antigen typing before first transfusion and issue of antigen matched blood (at least for Rh and Kell antigen).Early institution of transfusion therapy after diagnosis is another means of decreasing alloimmunization