Original Article

Frequency of Kell and Rh Alloantibodies in Iranian Thalassemia Patients in Khorasan Razavi Province, Iran

Abstract

Background:  Thalassemia is an inherited disease with anemia and hemolysis. Blood transfusion is a routine treatment for thalassemia patients; alloimmunization is one of the complications of blood transfusion, which is very serious for these patients, especially girls and young women.   

Materials and Methods:  Four hundred forty-six thalassemia patients were examined in this cross-sectional study. Demographic information of patients was extracted and recorded. The phenotype of ABO, Rh, and Kell antigens (tube method) with antisera from IMMUNDIANOSTICA Company (Germany) and the frequency of alloantibodies were determined.

Results: 55.8% of the studied individuals were male and 44.2% were female. The mean age of the studied patients was 19.94±10.63.  The alloantibodies were detected in 7.5% of pack cell receivers. The most prevalent phenotype of the ABO system was the O blood group (37.4%), and the most abundant antigen of the Rh group was ‘e’, which was found in 99.8% of the studied population. The most frequently detected alloantibody was Anti K (38.2%); concerning kell phenotype, (K_k+) and (K+k+) were found in 99.3% and 0.7% of patients, respectively. The frequency of Anti-D, Anti-C, Anti-c, and Anti-E was 23.5%, 14.7%, 2.9%, and 14.7%, respectively.

Conclusion: According to the results of this paper, finding the compatible pack cells in terms of Kell and Rh systems antigens in addition to the ABO blood group is recommended to decrease the rate of alloantibodies in thalassemia patients.

1. Datta SS, Mukherjee S, Talukder B, et al. Frequency of red cell alloimmunization and autoimmunization in thalassemia patients: a report from Eastern India. Adv Hematol. 2015;2015:610931.
2. Wonke B. Clinical management of beta-thalassemia major. Semin Hematol. 2001;38(4):350-9.
3. Stainsby D, Russell J, Cohen H, Lilleyman J. Reducing adverse events in blood transfusion. Br J Haematol. 2005;131(1):8-12.
4.Chen W, Wen J, Li F, et al. Frequencies of ABO, Rh and Kell phenotypes in couples from Han, Kazak, Uyghur and Hui in Xinjiang: an inheritance simulation model for blood group incompatibility in new-born. Blood and Genomics. 2018;2(1):39-44.
5. Azarkeivan A, Ahmadi MH, Zolfaghari S, et al. RBC alloimmunization and double alloantibodies in thalassemic patients. Hematology. 2015;20(4):223-7.
6. Waheed U, Arshad M, Saeed M, et al. Spectrum of alloimmunization among multitransfused beta-thalassemia major patients. Glob J Transfus Med. 2019;4(1):39-44.
7. Mohamadimaram M, Gharehbaghian A, Baghestani A, et al. The prevalence of undesired blood group antibodies in Imam Khomeini Hospital Complex patients. Sci J Iran Blood Transfus Organ. 2019;16(2):82-90.
8. Pahuja S, Pujani M, Gupta SK, et al. Alloimmunization and red cell autoimmunization in multitransfused thalassemics of Indian origin. Hematology. 2010;15(3):174-7.
9. Sadeghian MH, Keramati MR, Badiei Z, et al. Alloimmunization among transfusion-dependent thalassemia patients. Asian J Transfus Sci. 2009;3(2):95-8.
10. Parker V, Tormey CA. The direct antiglobulin test: indications, interpretation, and pitfalls. Archives of pathology & laboratory medicine. 2017;141(2):305-(6).
11. Adewoyin A, Lee G, Adeyemo T, et al. Rh and Kell blood group antigen prevalence in a multi-ethnic cohort in Nigeria: implications for local transfusion service. Immunohematology. 2018;34(2):61-5.
12. Shamsian B, Arzanian MT, Shamshiri AR, et al. Frequency of red cell alloimmunization in patients with beta-major thalassemia in an Iranian referral hospital. Iran J Pediatr.2008;18(2):149-153
13. Keikhaei B, Far AH, Abolghasemi H, et al. Red blood cell alloimmunization in patients with thalassemia major and intermediate in southwest Iran. Iran J Blood Cancer. 2013;6(1):41-6.
14.Karimi M, Nikrooz P, Kashef S, et al. RBC alloimmunization in blood transfusion‐dependent β‐thalassemia patients in southern Iran. Int J Lab Hematol. 2007;29(5):321-6.
15. Al‐Riyami AZ, Al‐Muqbali A, Al‐Sudiri S, et al. Risks of red blood cell alloimmunization in transfusion‐dependent β‐thalassemia in Oman: a 25‐year experience of a university tertiary care reference center and a literature review. Transfusion. 2018;58(4):871-8.
16. Qidwai A, Mansoor N, Syeda A, et al. Trends of red cell alloimmunization in β thalassemia major patients: A single center retrospective study in Karachi. J Blood Disord Treat. 2018;1(1):3-5.
17. Bhatti FA, Salamat N, Nadeem A, et al. Red cell immunization in beta thalassaemia major. J Coll Physicians Surg Pak. 2004;14(11):657-60.
18. Hassan K, Younus M, Ikram N, et al. Red cell alloimmunization in repeatedly transfused thalassemia major patients. Int J Pathol. 2004;2(1):16-9.
19. Ansari S, Voosogh P, Moshtaghian S. Assessment of frequency of alloimmunization and erythrocyte autoimmunization in transfusion dependent thalassemia patients. Acta Medica Iranica. 2008;64(2):137-40.
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IssueVol 17, No 1 (2023) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijhoscr.v17i1.11707
Keywords
Thalassemia; Kell blood group system; Rh system; Antibody
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How to Cite
1.
Mollahoseini Foomani F, Sadeghain MH, Bagheri S, Badiee Z, Bazargani R, Aryanpour Z, Hallajian S, Shams SF. Frequency of Kell and Rh Alloantibodies in Iranian Thalassemia Patients in Khorasan Razavi Province, Iran. Int J Hematol Oncol Stem Cell Res. 2023;17(1):4-8.