目的:镰状细胞病(SCD)是全球常见的遗传性血红蛋白疾病。SCD患者的主要治疗方法之一是需要输血。使用红细胞(RBC)抗原的输血后同种免疫仍然是SCD的主要危险因素。这项研究的目的是确定比率,自然,以及我们中心SCD儿科患者红细胞同种免疫的危险因素,并将我们的结果与沙特阿拉伯SA的已发表报告进行比较,区域国家,和一些国际国家。
方法:对吉达国王阿卜杜勒阿齐兹医疗城的SCD患者进行回顾性图表回顾,在2008年至2019年期间进行。记录人口统计学特征和输血史。使用免疫血液学技术分析血液样品的同种免疫。
结果:总计,对121例患者进行分析。21例患者(17.4%)检测到同种抗体,15例患者(71.4%)大多为单一抗体,抗K(23.7%),抗E(19.0%),和抗S(9.5%)。其他6例患者(28.6%)有多种同种抗体,特别是抗C和抗K的组合(9.5%)以及抗C和抗E的组合(9.5%)。经常住院(每年>5次)的患者的同种抗体水平明显更高,那些交换输血的人,3岁以下的人,和接受大量血液单位的人(P≤0.05)。
结论:与其他国家相比,红细胞同种免疫率被确定并被认为相对较低。匹配延伸的红细胞抗原,包括ABO,RH(D,C,C,E,e),K,Fya,FYB,Jka,强烈建议在供者和受者的筛查小组中使用Jkb抗原,以确保更好的输血实践并避免与输血相关的并发症.
OBJECTIVE: Sickle cell disease (SCD) is a common hereditary hemoglobin disorder worldwide. One of the main treatments for patients with SCD is the requirement for blood transfusions. Posttransfusion alloimmunization with red blood cell (RBC) antigens continues to be a major risk factor for SCD. The objective of this study was to determine the rate, nature, and risk factors of red cell alloimmunization among pediatric patients with SCD in our center and compare our results with published reports from Saudia Arabia SA, regional countries, and some international countries.
METHODS: A retrospective chart review of patients with SCD at King Abdulaziz Medical City-Jeddah, between 2008 and 2019 was performed. Demographic characteristics and transfusion histories were recorded. Blood samples were analyzed for alloimmunization using immunohematologic techniques.
RESULTS: In total, 121 patients were analyzed. Alloantibodies were detected in 21 patients (17.4%) and were mostly single in 15 patients (71.4%), anti-K (23.7%), anti-E (19.0%), and anti-S (9.5%). The other 6 patients (28.6%) had multiple alloantibodies, especially the combination of anti-C and anti-K (9.5%) and the combination of anti-C and anti-E (9.5%). Alloantibody levels were significantly higher in patients with frequent hospital admissions (>5 times annually), those who had an exchange blood transfusion, those younger than 3 years old, and those who received a larger number of blood units ( P ≤0.05).
CONCLUSIONS: The rate of RBC alloimmunization is determined and considered relatively low compared with that in other nations. Matching for extended RBC antigens to include ABO, RH (D, C, c, E, e), K, Fy a , Fy b , Jk a , and Jk b antigens in the screening panel for donors and recipients is highly recommended to ensure better transfusion practices and avoid transfusion-related complications.