A Meta Analysis of RBC Alloimmunization in Transfused Sickle Cell and Thalassemia Patients in Saudi Arabia.

Abstract

Background: Alloimmunization to red blood cells (RBCs) presents a significant challenge in blood transfusion for individuals afflicted with sickle cell disease (SCD) and thalassemia. However, there is a scarcity of data regarding the prevalence of RBC alloimmunization in such patients in Saudi Arabia. To address this gap, a comprehensive meta-analysis was undertaken to ascertain the rate of RBC alloimmunization in SCD and thalassemia patients who receive regular transfusions in Saudi Arabia.

Methods: A systematic search and subsequent meta-analysis, following PRISMA guidelines, were carried out. We meticulously combed through six prominent scientific databases, including PubMed, Web of Science, SCOPUS, EMBASE, MEDLINE, and Google Scholar, up to July 20, 2023, to identify pertinent English-language articles. Data were meticulously extracted from the selected studies. The meta-analysis adopted a random-effects model and included subgroup analyses to delineate the RBC alloimmunization rates specifically for SCD and thalassemia patients receiving regular transfusions. Heterogeneity was assessed through Cochran's Q and I2 tests. The study protocol was registered under PROSPERO, with the code CRD42023440761.

Results: Our comprehensive search yielded a total of 983 articles, with 12 meeting the criteria for the final analysis, encompassing a total of 1,811 SCD and thalassemia patients. The collective RBC alloimmunization rate across all the eligible articles for patients with SCD and thalassemia who received regular transfusions in Saudi Arabia was determined to be 18.2%. Subgroup analysis, comprising nine articles, indicated that the RBC alloimmunization rate among SCD patients was 18.6%, while analysis of six articles revealed that the rate among thalassemia patients stood at 19.5%.

Conclusions: This meta-analysis underscores that the RBC alloimmunization rate in SCD and thalassemia patients who regularly receive transfusions in Saudi Arabia stands at 18.2%. Considering these findings, it is essential to prioritize extended phenotyping prior to transfusion to significantly reduce the risk of RBC alloimmunization.