The prevalence of cumulative alloimmunization in patients with sickle cell disease at King Fahad University Hospital

Abstract

BACKGROUND: Sickle cell disease (SCD) is caused by a mutation in the beta-globin gene. Red blood cell (RBC) transfusion is considered the mainstay of management. On the other hand, it carries many side effects, of which alloimmunization is the most significant. AIMS AND OBJECTIVES: The aim of this study is to identify the prevalence of alloimmunization among SCD patients and its relation with other independent risk factors in order to provide recommendations for the care of SCD patients. MATERIALS AND METHODS: This is a retrospective cohort study conducted at King Fahad Hospital of the University in Al-Khobar from January 1, 2010, to December 31, 2018. Data were collected from both the QuadraMed electronic system and the blood bank transfusion cards. Data were analyzed using IBM SPSS (version 23.0, Chicago, IL, USA). RESULTS: One hundred and seven out of 556 SCD patients developed alloantibodies with a prevalence of (19.2%). Anti-E was the most identified alloantibody in 37 (34.6%) patients, followed by anti-K in 33 (30.8%) of the alloimmunized SCD patients. We found a clinically significant correlation between the alloimmunization and age and direct antiglobulin test positivity. CONCLUSION: Alloimmunization is a major complication among SCD patients. Moreover, most of the formed alloantibodies were directed toward the Rh and K antigens. All SCD patients should undergo extended RBC phenotyping at the earliest opportunity, including the following RBC antigens (C/c, E/e, K, Jka/Jkb, Fya/Fyb, M/N, and S/s) at a minimum either serologically or by genotyping.