The Prevalence and Main Determinants of Red-Cell Alloimmunization among Iranian Beta-thalassemia Patients; A Multicentric Tertiary Hospital Study

Samaneh  Salarvand; Alireza  Abdollahi; Maryam  Sotudeh Anvari; Maedeh  Mahmoodi Ali abadi; Hassan  Sohrabinia; Sara  Naseri; Elham  Nazar

doi:10.18502/jimc.v9i2.21185

Samaneh Salarvand Department of Pathology, Imam Khomeini Complex Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Alireza Abdollahi Department of Pathology, Imam Khomeini Complex Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Maryam Sotudeh Anvari Clinical Pathology Department, Children’s Medical Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Maedeh Mahmoodi Ali abadi Central Laboratory of Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Hassan Sohrabinia Central Laboratory of Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Sara Naseri Department of Clinical Pathology, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
Elham Nazar Department of Pathology, Sina Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/jimc.v9i2.21185

Keywords: Beta-Thalassemia, Blood group antigens, Blood transfusion, Clergy, Erythrocytes, Iran, Prevalence, Thalassemia

Abstract

Background: The production of alloantibodies as an immunological reaction to blood cell transfusion is a therapeutic challenge in patients with beta-thalassemia. Determining the rate of this event and its related factors is very important in managing blood transfusion. This study aimed to assess the prevalence rate and main determinants of red-cell alloimmunization in Iran’s selected sample of patients with beta-thalassemia.

Methods: This cross-sectional study was performed on 265 beta-thalassemia patients scheduled for regular blood transfusions in Imam Khomeini Complex Hospital and Children’s Medical Center as tertiary hospitals in 2021 and 2022. Along with baseline characteristics, special laboratory techniques also tracked the types of alloantibodies to red cell antigens.

Results: The overall rate of alloantibody positivity in thalassemia patients was 17.4%. The most common alloantibodies were anti-K in 10.6%, anti-E type in 4.5%, and anti-C in 2.3%.

Conclusion: Overall, 17.4% of beta-thalassemia patients in our population may face red-cell alloimmunization. Phenotyping and blood matching for K, E, and C antigens in patients with transfusion-dependent thalassemia could reduce the rate of RBC alloimmunization.