علل ایجاد آلوایمونیزاسیون در بیماران تالاسمی شیراز در سال 1395

Background and Objectives Estimation of the frequency and causes of immunization to red blood cells in transfusion dependent thalassemia (TDT) patients can help us know the limitations of current practice and plan specific measures to reduce it. This study aimed to evaluate the frequency and causes of immunization in TDT patients. Materials and Methods This case control study was conducted on 732 (TDT) patients between 20 November 2015 to November 2016 in Dastgheib Hospital, Shiraz, Iran. Direct coombs test, antibody screening, and antibody identification were performed for every TDT patient. Then, the frequency and type of antibodies were surveyed. Clinical and laboratory data of immunized and nonimmunized patients were compared. Results All of the case group had positive results in direct or indirect coombs tests. Indirect coombs test (ICT) was positive in 59 patients (63.4%) while direct coombs tests (DCT) was positive in 41 (44%) of immunized patients. In addition, 7 patients (7.52%) showed positive results for both DCT and IAT. The most frequent antibodies were against Kell (48.6%), D (22.7%) and E (18.2%). Our results reflected that lower age of starting transfusion and splenectomy had an impact on higher immunization rate. Conclusions Antbodies against Rh and Kell system were the most frequent antibodies. It seems that extended RBC matching at least for ABO/Rh/Kell antigens must be performed for thalassemia patients with its effect on RBC immunization rate to be then surveyed. [ABSTRACT FROM AUTHOR]