TY - JOUR
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 -