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Soubrier C, Jean E, De Sainte Marie B, Agouti I, Seguier J, Lavoipierre V, Clapasson C, Iline N, Gonin J, Giorgi R, Schleinitz N, Thuret I, Badens C, Bernit E. [Health status and quality of life in β-thalassemia adults in Marseille, France]. Rev Med Interne 2024; 45:187-193. [PMID: 38519305 DOI: 10.1016/j.revmed.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 11/17/2023] [Accepted: 01/01/2024] [Indexed: 03/24/2024]
Abstract
INTRODUCTION The life expectancy of β-thalassemia patients has increased over the last 20 years. In this study, we evaluated the current health status and quality of life of these patients managed in a reference center in Marseille. METHODS This is a single-center, descriptive study conducted between June and August 2019 in patients over 18 years of age with β-thalassemia major or intermedia. Clinical and paraclinical data were collected retrospectively and the SF-36 health survey questionnaire was proposed to each patient. RESULTS 43 of 64 selected patients were included and divided into 2 groups: 35 patients with transfusion-dependent β-thalassemia and 8 patients with non-transfusion-dependent β-thalassemia. Liver iron overload is the most frequent complication, present in 80% of transfusion-dependent and 62.5% of non-transfusion-dependent patients. Cardiac iron overload is present only in the transfusion dependent β-thalassemia group (20%). Hypogonadotropic hypogonadism remains the most common endocrine disorder (41.9%) followed by osteoporosis (37.2%). Among the 31 patients who completed the SF-36 questionnaire, physical and mental quality of life scores were lowered in transfusion dependent (respectively 42.7 and 46.8) as in non-transfusion-dependent patients (respectively 43.8 and 28.9). CONCLUSION Despite an improvement in medical care, our patients with β-thalassemia show an alteration in their quality of life that will need to be characterized in the entire French cohort.
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Affiliation(s)
- C Soubrier
- Service de médecine interne et médecine polyvalente, centre hospitalier d'Ajaccio Notre-Dame de la Miséricorde, site du Stilettu, 1180, route A.-Madunuccia, 20090 Ajaccio, France.
| | - E Jean
- Département de médecine interne, AP-HM, hôpital Timone, 264, rue Saint-Pierre, 13385 Marseille cedex, France
| | - B De Sainte Marie
- Département de médecine interne, AP-HM, hôpital Timone, 264, rue Saint-Pierre, 13385 Marseille cedex, France
| | - I Agouti
- Centre de référence des syndromes drépanocytaires majeurs, thalassémies et autres pathologies rares du globule rouge et de l'érythropoïèse, hôpital de la Timone, AP-PH, 264, rue Saint-Pierre, 13385 Marseille cedex, France
| | - J Seguier
- Département de médecine interne, AP-HM, hôpital Timone, 264, rue Saint-Pierre, 13385 Marseille cedex, France
| | - V Lavoipierre
- Service de médecine interne, centre hospitalier de Martigues, 3, boulevard des Rayettes, BP 50248, 13698 Martigues cedex, France
| | - C Clapasson
- Établissement français du sang, région PACA, 149, boulevard Baille, 13005 Marseille, France
| | - N Iline
- AP-HM, Hop Timone, BioSTIC, biostatistiques et technologies de l'information et de la communication, Marseille, France
| | - J Gonin
- AP-HM, Hop Timone, BioSTIC, biostatistiques et technologies de l'information et de la communication, Marseille, France
| | - R Giorgi
- AP-HM, Hop Timone, BioSTIC, biostatistiques et technologies de l'information et de la communication, Marseille, France; Aix Marseille université, AP-HM, Inserm, IRD, SESSTIM, sciences économiques & sociales de la santé & traitement de l'information médicale, ISSPAM, Marseille, France
| | - N Schleinitz
- Département de médecine interne, AP-HM, hôpital Timone, 264, rue Saint-Pierre, 13385 Marseille cedex, France; Aix-Marseille université, Marseille, France
| | - I Thuret
- Centre de référence des syndromes drépanocytaires majeurs, thalassémies et autres pathologies rares du globule rouge et de l'érythropoïèse, hôpital de la Timone, AP-PH, 264, rue Saint-Pierre, 13385 Marseille cedex, France
| | - C Badens
- Laboratoire de biochimie, AP-HM, hôpital Timone, 264, rue Saint-Pierre, 13385 Marseille cedex, France
| | - E Bernit
- Unité transversale de la drépanocytose, centre de référence Antilles-Guyane pour la drépanocytose, les thalassémies et les maladies constitutives du globule rouge et de l'érythropoïèse, CHU Guadeloupe, pôle parents-enfants, hôpital Ricou, BP465, 97159 Pointe-à-Pitre cedex, France
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Wilson MM, El Masry MMW, El-Ghamrawy MK, El-Hadi NA, Abou-Elalla AA. Study of the Frequency and Specificity of Red Cell Antibodies in Patients with Hemoglobinopathies. Indian J Hematol Blood Transfus 2023; 39:579-585. [PMID: 37786822 PMCID: PMC10542054 DOI: 10.1007/s12288-023-01651-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 03/20/2023] [Indexed: 10/04/2023] Open
Abstract
Patients with thalassemia and sickle cell disease (SCD) require blood transfusions as part of their supportive care. However, one of the most serious side effects of this treatment is the risk of red cell alloimmunization. The goal of this study was to assess the prevalence and Specificity of red cell alloimmunization in Egyptian thalassemia and sickle cell anaemia patients. This study included 200 multi transfused Egyptian patients, one hundred and forty patients with transfusion dependent thalassaemia and sixty patients with sickle cell anaemia, who were attending the Paediatric Children Hospital-Cairo University at the period from March 2019 to October 2019. Alloantibody identification was made by Diamed- ID microtyping system. In the studied groups both thalassemia and sickle patients, the prevalence of alloimmunization was 22/200 (11%) patients. The two most often alloantibodies were, antibodies against Kell antigen (37%) and against E antigen (30%). The prevalence of alloimmunization was more in females in comparison to males, but it did not reach statistical significance and patients with thalassemia major had higher alloimmunization rates than other studied groups but was not statistically significant. In the D negative patients in the research group, alloimmunization demonstrated a statistically significant difference (p = 0.01). Age, gender, age of transfusion onset and splenectomy were not contributing factors to the antibody presence in the group of patients being investigated. Before receiving blood transfusions, extended red blood cell phenotyping should be thought of as a crucial procedure for hemoglobinopathies patients who would likely have several transfusions. It is advised that haemoglobinopathies patients in Egypt be checked through phenotyping of RBC units for Kell and all Rh antigens to be phenotyped before starting transfusion in these patients which is also standard of care for these patients presently.
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Affiliation(s)
- Manal M. Wilson
- Departments of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Manal M. W. El Masry
- Departments of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | - Nessma Abd El-Hadi
- Departments of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Amany A. Abou-Elalla
- Technology of Medical Laboratory Department, Faculty of Applied Health Science, Misr University for Science and Technology, Cairo, Egypt
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Red Blood Cell Alloimmunizations in Thalassaemia Patients With Regular Transfusion in China: a Systematic Review and Meta-Analysis. Transfus Clin Biol 2023; 30:256-262. [PMID: 36764573 DOI: 10.1016/j.tracli.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 02/11/2023]
Abstract
OBJECTIVE The development of red blood cell alloimmunization intensifies transfusion complication in thalassaemia patients. The purpose of this paper is to evaluate the existing evidence on the prevalence of erythrocyte alloimmunization in China by meta-analysis. We systematically searched cross-sectional studies regarding the alloimmunization of thalassaemia patients with regular blood transfusion in China from year 2000 to May 2021 in the Cochrane library, PubMed, EMBASE, Web of Science, and Chinese databases including CNKI, Wanfang Data, Vip and CBM. Data extraction and quality evaluation of the included studies were performed. Meta-analysis was performed using the DerSimonian and Laird random-effects models with inverse variance weighting. The presence of publication bias was tested by Egger's test, and the methodological quality of each included article was evaluated by the criteria specific to prevalence studies. RESULTS A total of 1874 patients and 263 alloantibodies from 11 studies were identified and included in the meta-analysis. The proportion of alloantibodies against antigens belonging to the Rh, MNSs and Kidd systems were as high as 70.3%, 17.9%, and 6.5%, respectively. Meta-analysis showed that the overall prevalence of alloimmunization among transfusion-dependent thalassaemia patients in China is 11.4% (95%CI: 7.2%∼16.3%). CONCLUSIONS The characteristics of red blood cell alloimmunization among thalassaemia patients with regular transfusion in China differ greatly from those in other countries. Therefore, transfusion strategies shall be actively adapted in line with thalassaemia patients in China to minimize the risk of alloimmunization.
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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 2022; 62:2039-2047. [PMID: 35986658 PMCID: PMC9560980 DOI: 10.1111/trf.17068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 07/07/2022] [Accepted: 07/18/2022] [Indexed: 11/28/2022]
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.
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Affiliation(s)
- Nattiya Teawtrakul
- Division of Hematology, Department of Internal Medicine, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Duantida Songdej
- Division of Hematology and Oncology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Chattree Hantaweepant
- Division of Hematology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Adisak Tantiworawit
- Division of Hematology, Department of Internal Medicine, Chiang Mai University, Chiang Mai, Thailand
- Thalassemia and Hematology Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Supanun Lauhasurayotin
- Division of Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Kitti Torcharus
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Phramongkutklao College of Medicine, Bangkok, Thailand
| | - Pornpun Sripornsawan
- Division of Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkla, Thailand
| | - Pranee Sutcharitchan
- Division of Hematology, Department of Internal Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Pacharapan Surapolchai
- Division of Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
| | - Patcharee Komvilaisak
- Division of Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Supawee Saengboon
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
| | - Bunchoo Pongtanakul
- Division of Hematology and Oncology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Pimlak Charoenkwan
- Thalassemia and Hematology Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Division of Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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El-Beshlawy A, Salama AA, El-Masry MR, El Husseiny NM, Abdelhameed AM. A study of red blood cell alloimmunization and autoimmunization among 200 multitransfused Egyptian β thalassemia patients. Sci Rep 2020; 10:21079. [PMID: 33273689 PMCID: PMC7713136 DOI: 10.1038/s41598-020-78333-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 09/24/2020] [Indexed: 01/27/2023] Open
Abstract
The development of hemolytic erythrocyte alloantibodies and autoantibodies complicates transfusion therapy in thalassemia patients. These antibodies ultimately increase the need for blood and intensify transfusion complications. There is a scanty data on the frequency of RBC alloimmunization and autoimmunization in Egyptian β thalassemia patients as pretransfusion antibody screening is not routinely performed. We studied the frequency of alloimmunization and autoimmunization among 200 multiply transfused β thalassemia patients and investigated the factors that possibly affect antibody formation. Of the 200 patients in our study, 94 were males and 106 females, with the age range of 2–37 years. Alloantibodies were detected in 36 (18%) of the patients, while autoantibodies were detected in 33 (16.5%). The dominant alloantibodies were directed against Kell (33%) and Rh (24.4%) groups. Alloimmunization had a significant relationship with treatment duration and the frequency of transfusion (P = 0.007, 0.001, respectively). The presence of autoantibodies was significantly related to age (P = 0.001), total number of transfused units (P = 0.000) and splenectomy (P = 0.000). The high prevalence of alloimmunization in the study population disclosed the need for providing phenotypically matched cells for selective antigens especially for Kell and Rh subgroups to reduce risk of alloimmunization and increase the efficiency of blood transfusion.
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Affiliation(s)
- Amal El-Beshlawy
- Department of Pediatric Haematology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | - Mohamed Roshdy El-Masry
- Department of Internal Medicine and Clinical Haematology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Noha M El Husseiny
- Department of Internal Medicine and Clinical Haematology, Faculty of Medicine, Cairo University, Cairo, Egypt.,Armed Forces College of Medicine (AFCM), Cairo, Egypt
| | - Asmaa M Abdelhameed
- Department of Internal Medicine and Clinical Haematology, Faculty of Medicine, Cairo University, Cairo, Egypt. .,Armed Forces College of Medicine (AFCM), Cairo, Egypt.
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