Red blood cell alloimmunization and other transfusion-related complications in patients with transfusion-dependent thalassemia: A multi-center study in Thailand
Issued Date
2022-10-01
Resource Type
ISSN
00411132
eISSN
15372995
Scopus ID
2-s2.0-85136486497
Pubmed ID
35986658
Journal Title
Transfusion
Volume
62
Issue
10
Start Page
2039
End Page
2047
Rights Holder(s)
SCOPUS
Bibliographic Citation
Transfusion Vol.62 No.10 (2022) , 2039-2047
Suggested Citation
Teawtrakul N., Songdej D., Hantaweepant C., Tantiworawit A., Lauhasurayotin S., Torcharus K., Sripornsawan P., Sutcharitchan P., Surapolchai P., Komvilaisak P., Saengboon S., Pongtanakul B., Charoenkwan P. Red blood cell alloimmunization and other transfusion-related complications in patients with transfusion-dependent thalassemia: A multi-center study in Thailand. Transfusion Vol.62 No.10 (2022) , 2039-2047. 2047. doi:10.1111/trf.17068 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/85503
Title
Red blood cell alloimmunization and other transfusion-related complications in patients with transfusion-dependent thalassemia: A multi-center study in Thailand
Author's Affiliation
Siriraj Hospital
Faculty of Medicine, Chiang Mai University
Faculty of Medicine, Khon Kaen University
Faculty of Medicine, Prince of Songkia University
King Chulalongkorn Memorial Hospital
Faculty of Medicine Ramathibodi Hospital, Mahidol University
Faculty of Medicine, Thammasat University
Phramongkutklao College of Medicine
Faculty of Medicine, Chulalongkorn University
Chiang Mai University
Faculty of Medicine, Chiang Mai University
Faculty of Medicine, Khon Kaen University
Faculty of Medicine, Prince of Songkia University
King Chulalongkorn Memorial Hospital
Faculty of Medicine Ramathibodi Hospital, Mahidol University
Faculty of Medicine, Thammasat University
Phramongkutklao College of Medicine
Faculty of Medicine, Chulalongkorn University
Chiang Mai University
Other Contributor(s)
Abstract
Background: Thalassemia is a common genetic disease in Southeast Asia. Red blood cell (RBC) transfusion is an essential treatment for severe forms of thalassemia. We performed a study to demonstrate RBC alloimmunization and other transfusion-related complications in patients with transfusion-dependent thalassemia (TDT). Study Design and Methods: A multi-center web-based registry of TDT was conducted in eight medical centers across Thailand. Thalassemia information, transfusion therapy, and transfusion-related complications were collected. Factors associated with each complication were demonstrated using the logistic regression analysis. Results: Of 1000 patients recruited for the study, 449 were males (44.9%). The mean age was 23.9 ± 15.4 years. The majority of patients, 738 (73.8%) had hemoglobin E/beta-thalassemia. In the study, 421 transfusion-related complications were reported from 357 patients (35.7%). Alloimmunization was the most common complication which was found in 156 patients (15.6%) with 284 positive antibody tests. The most frequent antibodies against RBC were anti-E (80/284, 28.2%) followed by anti-Mia (45/284, 15.8%) and anti-c (32/284, 11.3%). Age ≥3 years at initial blood transfusion, splenomegaly, higher frequencies, and volumes of transfusion were significant factors associated with alloimmunization. None of the patients had to terminate blood transfusion due to multiple alloantibodies. Other commonly seen complications were allergic reactions (130, 13.0%), autoimmune hemolytic anemia (70, 7.0%) and febrile non-hemolytic transfusion reaction (54, 5.4%). Conclusions: Transfusion-related complications, especially alloimmunization, were common among Thai patients with TDT. Extended RBC antigen-matching for the Rh system and Mia should be implemented to prevent the development of alloantibodies in multi-transfused patients.