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S. Abdullah SZ, Hassan MN, Ramli M, Abdullah M, Mohd Noor NH. Red Blood Cell Alloimmunization and Its Associated Factors among Chronic Liver Disease Patients in a Teaching Hospital in Northeastern Malaysia. Diagnostics (Basel) 2023; 13:diagnostics13050886. [PMID: 36900030 PMCID: PMC10001194 DOI: 10.3390/diagnostics13050886] [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: 01/31/2023] [Revised: 02/16/2023] [Accepted: 02/16/2023] [Indexed: 03/02/2023] Open
Abstract
Red blood cell (RBC) alloimmunization is an important complication of blood transfusion. Variations in the frequency of alloimmunization have been noted among different patient populations. We aimed to determine the prevalence of RBC alloimmunization and associated factors among chronic liver disease (CLD) patients in our center. This is a case-control study involving 441 patients with CLD who were being treated at Hospital Universiti Sains Malaysia and subjected to pre-transfusion testing from April 2012 until April 2022. Clinical and laboratory data were retrieved and statistically analyzed. A total of 441 CLD patients were included in our study, with the majority being elderly, with the mean age of patients 57.9 (SD ± 12.1) years old, male (65.1%) and Malays (92.1%). The most common causes of CLD in our center are viral hepatitis (62.1%) and metabolic liver disease (25.4%). Twenty-four patients were reported to have RBC alloimmunization, resulting in an overall prevalence of 5.4%. Higher rates of alloimmunization were seen in females (7.1%) and patients with autoimmune hepatitis (11.1%). Most patients developed a single alloantibody (83.3%). The most common alloantibody identified belonged to the Rh blood group, anti-E (35.7%) and anti-c (14.3%), followed by the MNS blood group, anti-Mia (17.9%). There was no significant factor association of RBC alloimmunization among CLD patients identified. Our center has a low prevalence of RBC alloimmunization among CLD patients. However, the majority of them developed clinically significant RBC alloantibodies, mostly from the Rh blood group. Therefore, phenotype matching for Rh blood groups should be provided for CLD patients requiring blood transfusions in our center to prevent RBC alloimmunization.
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Affiliation(s)
- Siti Zaleha S. Abdullah
- Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
| | - Mohd Nazri Hassan
- Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
- Transfusion Medicine Unit, Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
- Correspondence: (M.N.H.); (N.H.M.N.); Tel.: +60-9767-6198 (M.N.H.); +60-9767-6196 (N.H.M.N.)
| | - Marini Ramli
- Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
- Transfusion Medicine Unit, Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
| | - Marne Abdullah
- Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
- Transfusion Medicine Unit, Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
| | - Noor Haslina Mohd Noor
- Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
- Transfusion Medicine Unit, Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
- Correspondence: (M.N.H.); (N.H.M.N.); Tel.: +60-9767-6198 (M.N.H.); +60-9767-6196 (N.H.M.N.)
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A clinical effect of disease-modifying treatment on alloimmunisation in transfused patients with myelodysplastic syndromes: data from a population-based study. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2022; 20:18-26. [PMID: 33370223 PMCID: PMC8796846 DOI: 10.2450/2020.0168-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 11/09/2020] [Indexed: 01/24/2023]
Abstract
BACKGROUND Alloimmunisation against blood products is an adverse event, causing time-consuming compatibility testing. Current literature has not yet identified the influence of treatment on the risk of alloimmunisation in patients with myelodysplastic syndromes (MDS). MATERIALS AND METHODS An observational, population-based study, using the HemoBase registry, was performed including all transfused patients who were diagnosed with MDS between 2005 and 2017 in Friesland, a province in the Netherlands. Information about transfusion dates, types, and treatment regimens was collected from the health records. Blood products were matched for ABO and Rhesus D. The effect of disease-modifying treatment was estimated with incidence rates and a Cox time-dependent analysis. RESULTS 233 patients were included in this study, with a median follow-up of 13.0 months. Alloimmunisation occurred in 21 patients (9.0%) and predominantly occurred early in follow-up. Three (5%) and 18 (11%) alloimmunisation events occurred in patients with and without disease-modifying treatment, respectively. The hazard ratio for alloimmunisation without treatment compared to during treatment was 2.7 (95% CI: 0.35-20.0), with incidence rates of 7.18 and 2.41 per 100 patient-years, respectively. DISCUSSION In a non-selected real-world population of MDS patients receiving blood transfusions, the percentage of patients with alloimmunisation was below 10%. The results of this study support the hypothesis that disease-modifying treatment affects the ability of the immune system to mount an antibody response to non-self blood group antigens.
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Kaka S, Jahangirnia A, Beauregard N, Davis A, Tinmouth A, Chin-Yee N. Red blood cell transfusion in myelodysplastic syndromes: A systematic review. Transfus Med 2021; 32:3-23. [PMID: 34927286 DOI: 10.1111/tme.12841] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 11/06/2021] [Accepted: 11/11/2021] [Indexed: 11/28/2022]
Abstract
Patients with myelodysplastic syndrome (MDS) frequently receive red blood cell (RBC) transfusions for anaemia resulting from ineffective erythropoiesis. While RBC transfusions may rapidly increase haemoglobin values, their impact on clinical and health services outcomes in MDS patients has not previously been summarized. We conducted a systematic review of the literature to evaluate risks and benefits of RBC transfusions in MDS patients. We searched electronic databases (MEDLINE, Embase, CENTRAL, CINAHL) from inception through June 4, 2021 to identify studies reporting data on RBC transfusions in MDS patients. Full text publications that assessed RBC transfusions as an intervention and reported at least one clinical, laboratory, or healthcare outcome associated with transfusion were included. Study characteristics, transfusion information and transfusion-related outcomes were extracted and reported. We identified 1243 original studies, of which 38 met eligibility requirements and were included. Fourteen reported on survival following diagnosis of MDS, with the majority reporting poorer survival among patients receiving or requiring more frequent transfusions. Nine reported on transfusion-related iron overload and its complications. Other outcomes included rates of allo/autoimmunization and adverse transfusion reactions, and healthcare costs incurred by patients with a greater transfusion burden. Only two studies reported on symptom relief following transfusion. This review underscores transfusion dependence as a negative prognostic factor for MDS patients and highlights the paucity of evidence surrounding quality of life and symptom-related outcomes following RBC transfusions in this population. Further study of patient-important outcomes associated with transfusion in MDS patients is warranted to improve therapeutic recommendations and inform resource allocation.
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Affiliation(s)
- Shaima Kaka
- Faculty of Medicine, University of Ottawa/The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Ashkan Jahangirnia
- Faculty of Medicine, University of Ottawa/The Ottawa Hospital, Ottawa, Ontario, Canada
| | | | - Alexandra Davis
- Faculty of Medicine, University of Ottawa/The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Alan Tinmouth
- Faculty of Medicine, University of Ottawa/The Ottawa Hospital, Ottawa, Ontario, Canada.,The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Nicolas Chin-Yee
- University of Toronto, Toronto, Ontario, Canada.,Department of Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
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Wang H, Williams GR, Xie X, Wu M, Wu J, Zhu LM. Stealth Polydopamine-Based Nanoparticles with Red Blood Cell Membrane for the Chemo-Photothermal Therapy of Cancer. ACS APPLIED BIO MATERIALS 2020; 3:2350-2359. [DOI: 10.1021/acsabm.0c00094] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Haijun Wang
- College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai 201620, China
| | - Gareth R. Williams
- UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, U.K
| | - Xiaotian Xie
- College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai 201620, China
| | - Meng Wu
- College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai 201620, China
| | - Junzi Wu
- College of Basic Medicine, Yunnan University of Chinese Medicine, Kunming 650500, China
| | - Li-Min Zhu
- College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai 201620, China
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Jekarl DW, Yoo J, Lee S, Yu H, Kim M, Kim Y. Blood group antigen and phenotype prevalence in the Korean population compared to other ethnic populations and its association with RBC alloantibody frequency. Transfus Med 2019; 29:415-422. [PMID: 31646705 DOI: 10.1111/tme.12643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 09/19/2019] [Accepted: 09/24/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study aimed to analyse the allele frequency of blood group antigens in the Korean population and other ethnic populations and the association of blood group antigens with red blood cell (RBC) alloantibodies. BACKGROUND Blood group antigen genotyping can support patients undergoing frequent transfusions who have alloantibodies and antibodies against high-prevalence blood group antigens. METHODS Twenty-nine single nucleotide variations and 37 blood group antigens were tested. Samples requested for routine blood typing were collected from Jan to Apr 2016. Genotyping was performed on 145 Korean samples and was confirmed by bidirectional sequencing and serologic tests. The allele frequency data were compared with previous genotyping datasets (three datasets from Korea and one each from China, Europe, Asia, and the USA). Alloantibody frequencies and blood group antigens from the electronic medical record of 1772 cases were examined. RESULTS E antigen was higher in the Korean population compared to that of Asian and European populations. K, Kpa , Fyb and Doa allele frequencies were lower compared to other ethnic populations. RBC alloantibodies with frequencies (%) greater than 1% from the 1772 cases were as follows: anti-E, 36·7%, anti-C, 17·7%; anti-c 7·39%; anti-M, 5·9%; anti-e, 5·2%; anti-Jka , 2·9%; and anti-Fya , 1·1%. Blood group antigens and alloantibody frequencies revealed inverse trends that did not reach statistical significance. CONCLUSION The allele frequency of blood group antigens assessed by high-throughput methods provided reliable and valuable information that could be used for maintaining donor pools and providing compatible blood for genotyped patients.
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Affiliation(s)
- D W Jekarl
- Department of Laboratory Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,Laboratory for Development and Evaluation Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - J Yoo
- Laboratory for Development and Evaluation Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,Department of Laboratory Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - S Lee
- Department of Laboratory Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,Laboratory for Development and Evaluation Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - H Yu
- Laboratory for Development and Evaluation Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,Department of Laboratory Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - M Kim
- Laboratory for Development and Evaluation Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,Department of Laboratory Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Y Kim
- Laboratory for Development and Evaluation Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,Department of Laboratory Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Balbuena-Merle RI, Nazario-Delgado CM, Rosario-Rosado RV, Millán-Tapia D, Climent-Peris C. Red Blood Cell Alloimmunization in Pediatric Sickle Cell Disease Population of Puerto Rico: An Observational Study. Ann Lab Med 2019; 40:187-189. [PMID: 31650739 PMCID: PMC6822008 DOI: 10.3343/alm.2020.40.2.187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 07/05/2019] [Accepted: 10/01/2019] [Indexed: 11/20/2022] Open
Affiliation(s)
- Raisa I Balbuena-Merle
- Department of Pathology and Laboratory Medicine, School of Medicine, University of Puerto Rico, San Juan, Puerto Rico, USA.,Yale University, Department of Laboratory Medicine, New Haven, CT, USA.
| | - Cruz M Nazario-Delgado
- Graduate School of Public Health, School of Medicine, University of Puerto Rico, San Juan, Puerto Rico, USA
| | - Rosa V Rosario-Rosado
- Graduate School of Public Health, School of Medicine, University of Puerto Rico, San Juan, Puerto Rico, USA
| | - Dalia Millán-Tapia
- Medical Services Administration of Puerto Rico, Clinical Laboratory Transfusion Service, San Juan, Puerto Rico, USA
| | - Consuelo Climent-Peris
- Department of Pathology and Laboratory Medicine, School of Medicine, University of Puerto Rico, San Juan, Puerto Rico, USA.,Medical Services Administration of Puerto Rico, Clinical Laboratory Transfusion Service, San Juan, Puerto Rico, USA
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Kim HY, Chung YN, Cho D. Extended Red Blood Cell Phenotype Matching Is Dependent on Ethnicity and Specificity of RBC Alloantibodies. Ann Lab Med 2019; 40:190-192. [PMID: 31650740 PMCID: PMC6822005 DOI: 10.3343/alm.2020.40.2.190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 10/10/2019] [Accepted: 10/14/2019] [Indexed: 11/19/2022] Open
Affiliation(s)
- Hyun Young Kim
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yoo Na Chung
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Duck Cho
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea.
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