Red Cell Alloimmunization in Repeatedly Transfused Thalassemia Major Patients

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Professor, Consultant Pathologist, American Board Certified Pathologist, Fellow College of American Pathologists. Areas of interest Fine Needle Aspiration Cytology, Cytology, Cancer, Ethics, Islam, Humanity

Red Cell Alloimmunization in Repeatedly Transfused Thalassemia Major Patients

Khalid Hassan, Muhammad Younus, Nadeem Ikram*, Lubna Naseem and Hassan Abbas Zaheer
Department of Pathology, Pakistan Institute of Medical Sciences, Islamabad
* Department of Pathology, Rawalpindi Medical College, Rawalpindi
Thalassemia major patients managed by regular transfusion regimen may develop anti-red cell alloimmunization. If the alloantibodies are hemolyzing in nature, transfusion reaction may occur, and provision of blood thereafter requires matching of the relevant blood group in addition to ‘ABO” and Rh ‘D’ matching. We investigated 75 cases of multiply transfused thalassemia major patients for development of alloantibodies against red cells by indirect antiglobulin test, using 3-red cell panel, and when required 11-red cell panel. Anti-red cell alloantibodies were detected in 17 (22.7%) patients. Anti-Kpa antibodies were the commonest, followed by Anti-e, anti-E and anti-K antibodies, respectively. Anti-k, -CW, -Fyb, -Kpb, -Rh ‘D’ and –c were detected in one patient each. It is concluded that in multiply transfused patients, alloantibodies develop in a significant number of patients. The hemolyzing nature of antibodies should be determined in patients who develop these antibodies, and transfusion should be arranged accordingly
Key words: Red Cell Alloimmunization; Alloantibodies; Thalassemia Major; Multiple Transfusions.


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