Korean J Blood Transfus.  2022 Apr;33(1):14-23. 10.17945/kjbt.2022.33.1.1 4.

Characteristics of Red Blood Cell Alloimmunization in Patients with Hematologic Diseases

• An GD
• Kim KH

• KMID: 2529874
• DOI: http://doi.org/10.17945/kjbt.2022.33.1.1 4

Abstract

Background
Patients with hematologic diseases receive frequent transfusions of red blood cells (RBCs), platelets (PLTs), and fresh frozen plasma (FFP). These patients are more likely to develop alloimmunization due to repeated exposure to RBC antigens. The purpose of this study was to investigate the need for extended RBC matching in patients with hematologic diseases and a history of repeated transfusions.
Methods
We assessed patients who had undergone bone marrow examination at the Dong-A University hospital, Busan, South Korea from January 2008 to December 2012. A total of 571 patients were examined. We retrospectively investigated the frequency and volume of the transfusions of RBCs, PLTs, and FFP, the diagnosis of each patient, and the generation of unexpected antibodies.
Results
Alloimmunization occurred in 18 out of 571 patients (3.15%). Among the identified antibodies, Rhesus (Rh) group antibodies were the most frequently detected (58.6%). The number of RBC transfusion episodes was higher in the alloimmunized group than that in the non-alloimmunized group (P=0.0016). The RBC transfusion volume was also significantly higher in the alloimmunized group than that in the non-alloimmunized group (P=0.0020). Also, the number of PLT transfusion episodes and transfusion volume were higher in the alloimmunized group. There were no statistically significant differences in the sex, age, or FFP transfusions between the two groups.
Conclusion
The number of RBC transfusion episodes and the RBC transfusion volume affected the possibility of generating unexpected antibodies. The number of PLT transfusion episodes and the PLT transfusion volume also affected alloimmunization. The Rh antigen should therefore be matched in elderly patients who are expected to receive repeated blood transfusions.

Keyword

Unexpected antibody; Alloimmunization; Extended RBC matching