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

Research output: Contribution to journalArticlepeer-review


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 languageEnglish
Pages (from-to)4-15
Number of pages12
JournalBlood Transfus
Issue number1
Publication statusPublished - Jan 2019


  • 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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