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

Massimo Franchini; Gian Luca Forni; Giuseppe Marano; Mario Cruciani; Carlo Mengoli; Valeria Pinto; Lucia De Franceschi; Donatella Venturelli; Maddalena Casale; Martina Amerini; Martina Capuzzo; Giuliano Grazzini; Francesca Masiello; Ilaria Pati; Eva Veropalumbo; Stefania Vaglio; Simonetta Pupella; Giancarlo M Liumbruno

doi:10.2450/2019.0229-18

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

Massimo Franchini, Gian Luca Forni, Giuseppe Marano, Mario Cruciani, Carlo Mengoli, Valeria Pinto, Lucia De Franceschi, Donatella Venturelli, Maddalena Casale, Martina Amerini, Martina Capuzzo, Giuliano Grazzini, Francesca Masiello, Ilaria Pati, Eva Veropalumbo, Stefania Vaglio, Simonetta Pupella, Giancarlo M Liumbruno

Istituto Superiore di Sanita'

Research output: Contribution to journal › Article › peer-review

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%.

Original language	English
Pages (from-to)	4-15
Number of pages	12
Journal	Blood Transfus
Volume	17
Issue number	1
DOIs	https://doi.org/10.2450/2019.0229-18
Publication status	Published - Jan 2019

Keywords

Erythrocyte Transfusion/adverse effects
Erythrocytes/immunology
Humans
Prevalence
Rh Isoimmunization/epidemiology
Rh-Hr Blood-Group System/immunology
Thalassemia/epidemiology
Transfusion Reaction/epidemiology

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10.2450/2019.0229-18

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Franchini, M., Forni, G. L., Marano, G., Cruciani, M., Mengoli, C., Pinto, V., De Franceschi, L., Venturelli, D., Casale, M., Amerini, M., Capuzzo, M., Grazzini, G., Masiello, F., Pati, I., Veropalumbo, E., Vaglio, S., Pupella, S., & Liumbruno, G. M. (2019). Red blood cell alloimmunisation in transfusion-dependent thalassaemia: a systematic review. Blood Transfus, 17(1), 4-15. https://doi.org/10.2450/2019.0229-18

Red blood cell alloimmunisation in transfusion-dependent thalassaemia : a systematic review. / Franchini, Massimo; Forni, Gian Luca; Marano, Giuseppe; Cruciani, Mario; Mengoli, Carlo; Pinto, Valeria; De Franceschi, Lucia; Venturelli, Donatella; Casale, Maddalena; Amerini, Martina; Capuzzo, Martina; Grazzini, Giuliano; Masiello, Francesca; Pati, Ilaria; Veropalumbo, Eva; Vaglio, Stefania; Pupella, Simonetta ; Liumbruno, Giancarlo M.

In: Blood Transfus, Vol. 17, No. 1, 01.2019, p. 4-15.

Research output: Contribution to journal › Article › peer-review

Franchini, M, Forni, GL, Marano, G, Cruciani, M, Mengoli, C, Pinto, V, De Franceschi, L, Venturelli, D, Casale, M, Amerini, M, Capuzzo, M, Grazzini, G, Masiello, F, Pati, I, Veropalumbo, E, Vaglio, S, Pupella, S & Liumbruno, GM 2019, 'Red blood cell alloimmunisation in transfusion-dependent thalassaemia: a systematic review', Blood Transfus, vol. 17, no. 1, pp. 4-15. https://doi.org/10.2450/2019.0229-18

Franchini, Massimo ; Forni, Gian Luca ; Marano, Giuseppe ; Cruciani, Mario ; Mengoli, Carlo ; Pinto, Valeria ; De Franceschi, Lucia ; Venturelli, Donatella ; Casale, Maddalena ; Amerini, Martina ; Capuzzo, Martina ; Grazzini, Giuliano ; Masiello, Francesca ; Pati, Ilaria ; Veropalumbo, Eva ; Vaglio, Stefania ; Pupella, Simonetta ; Liumbruno, Giancarlo M. / Red blood cell alloimmunisation in transfusion-dependent thalassaemia : a systematic review. In: Blood Transfus. 2019 ; Vol. 17, No. 1. pp. 4-15.

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title = "Red blood cell alloimmunisation in transfusion-dependent thalassaemia: a systematic review",

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%.",

keywords = "Erythrocyte Transfusion/adverse effects, Erythrocytes/immunology, Humans, Prevalence, Rh Isoimmunization/epidemiology, Rh-Hr Blood-Group System/immunology, Thalassemia/epidemiology, Transfusion Reaction/epidemiology",

author = "Massimo Franchini and Forni, {Gian Luca} and Giuseppe Marano and Mario Cruciani and Carlo Mengoli and Valeria Pinto and {De Franceschi}, Lucia and Donatella Venturelli and Maddalena Casale and Martina Amerini and Martina Capuzzo and Giuliano Grazzini and Francesca Masiello and Ilaria Pati and Eva Veropalumbo and Stefania Vaglio and Simonetta Pupella and Liumbruno, {Giancarlo M}",

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doi = "10.2450/2019.0229-18",

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T1 - Red blood cell alloimmunisation in transfusion-dependent thalassaemia

T2 - a systematic review

AU - Franchini, Massimo

AU - Forni, Gian Luca

AU - Marano, Giuseppe

AU - Cruciani, Mario

AU - Mengoli, Carlo

AU - Pinto, Valeria

AU - De Franceschi, Lucia

AU - Venturelli, Donatella

AU - Casale, Maddalena

AU - Amerini, Martina

AU - Capuzzo, Martina

AU - Grazzini, Giuliano

AU - Masiello, Francesca

AU - Pati, Ilaria

AU - Veropalumbo, Eva

AU - Vaglio, Stefania

AU - Pupella, Simonetta

AU - Liumbruno, Giancarlo M

PY - 2019/1

Y1 - 2019/1

N2 - 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%.

AB - 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%.

KW - Erythrocyte Transfusion/adverse effects

KW - Erythrocytes/immunology

KW - Humans

KW - Prevalence

KW - Rh Isoimmunization/epidemiology

KW - Rh-Hr Blood-Group System/immunology

KW - Thalassemia/epidemiology

KW - Transfusion Reaction/epidemiology

U2 - 10.2450/2019.0229-18

DO - 10.2450/2019.0229-18

M3 - Article

C2 - 30653458

VL - 17

SP - 4

EP - 15

JO - Blood Transfus

JF - Blood Transfus

SN - 2385-2070

IS - 1

ER -

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

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