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PLASTIC RECONSTRUCTIVE AND REGENERATIVE SURGERY

Review

Blood Transfusion - 1 2019 (January-February)

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

Authors

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

Key words: thalassaemia, alloimmunisation, red blood cells, transfusion, complications
Doi: 10.2450/2019.0229-18
Publication Date: 2019-01-08

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%.
 

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Authors

Massimo Franchini Italian National Blood Centre, National Institute of Health, Rome; Department of Haematology and Transfusion Medicine, "Carlo Poma" Hospital, Mantua

Gian Luca Forni Centre for Microcythemia and Congenital Anaemia, "Galliera" Hospital, Genoa

Giuseppe Marano Italian National Blood Centre, National Institute of Health, Rome

Mario Cruciani Italian National Blood Centre, National Institute of Health, Rome; Infection Control Committee and Antibiotic Stewardship Programme, AULSS9 "Scaligera", Verona

Carlo Mengoli Italian National Blood Centre, National Institute of Health, Rome

Valeria Pinto Centre for Microcythemia and Congenital Anaemia, "Galliera" Hospital, Genoa

Lucia De Franceschi Department of Medicine, University of Verona and aoui-Verona, Policlinico "G.B. Rossi", Verona

Donatella Venturelli Department of Transfusion Medicine, University Hospital of Modena, Modena

Maddalena Casale Department of Women, Children and General and Specialised Surgery, "Luigi Vanvitelli" University of Campania, Naple

Martina Amerini Italian National Blood Centre, National Institute of Health, Rome; Italian Foundation for Research on Anaemia (FORANEMIA) and Haemoglobinopathies, Genoa

Martina Capuzzo Mother-Infant Department, University of Modena and Reggio Emilia, Modena

Giuliano Grazzini Italian National Blood Centre, National Institute of Health, Rome; Italian Foundation for Research on Anaemia (FORANEMIA) and Haemoglobinopathies, Genoa

Francesca Masiello Italian National Blood Centre, National Institute of Health, Rome

Ilaria Pati Italian National Blood Centre, National Institute of Health, Rome

Eva Veropalumbo Italian National Blood Centre, National Institute of Health, Rome

Stefania Vaglio Italian National Blood Centre, National Institute of Health, Rome; Department of Clinical and Molecular Medicine, "Sapienza" University of Rome, Rome, Italy

Simonetta Pupella Italian National Blood Centre, National Institute of Health, Rome

Giancarlo M. Liumbruno Italian National Blood Centre, National Institute of Health, Rome

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