Alloimmunization in sickle cell anemia in the era of extended red cell typing

Chibuzo O'Suoji*, Robert I Liem, Astrid Kyle Mack, Paris Kingsberry, Glenn Eugene Ramsey, Alexis A Thompson

*Corresponding author for this work

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Background: Red blood cell (RBC) transfusion remains an essential part of the management of patients with sickle cell disease (SCD). Alloimmunization is a major complication of transfusions. Extended RBC typing is advocated as a means to reduce alloimmunization in SCD. Our goal was to assess alloimmunization among individuals with SCD at our center since implementing extended RBC typing. Materials and Methods: We reviewed electronic medical records of all patients with SCD (N=641) in our comprehensive SCD Program to determine transfusion histories. Cross-referencing with our blood bank database, we extracted data such as antibodies identified, detection date and genotyping in specific cases. Transfusion sources were determined for those with C, E, and Kell antibodies. Results: Of 180 patients transfused from 2002 to 2011, 26 developed at least one new antibody. The majority of alloimmunized patients (14/26) received episodic transfusions only. The most common antibodies formed were against C and E antigens. Of the 16 patients who developed C, E, Kell antibodies, nine had one or more documented transfusions at an outside hospital. Five patients had Rh variants undetectable on routine phenotyping including two novel e alleles related to ceAR and ceS(733G). Conclusion: Despite extended RBC typing, alloimmunization may still occur due to RBC variants that are not detected on routine screening and transfusions at institutions where extended RBC typing is not done. Extended RBC typing should be the standard of care for patients with SCD. Prospective genotyping may reduce allosensitization to rare variants not detected on routine screening.

Original languageEnglish (US)
Pages (from-to)1487-1491
Number of pages5
JournalPediatric Blood and Cancer
Volume60
Issue number9
DOIs
StatePublished - Sep 1 2013

Fingerprint

Sickle Cell Anemia
Blood Grouping and Crossmatching
Erythrocytes
Antibodies
Erythrocyte Transfusion
Blood Banks
Electronic Health Records
Standard of Care
Alleles
Databases
Antigens

Keywords

  • Alloimmunization
  • Extended red cell typing
  • Red cell transfusion
  • Sickle cell anemia

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

Cite this

@article{7c9030d4cbdc4f599ba048128556a05b,
title = "Alloimmunization in sickle cell anemia in the era of extended red cell typing",
abstract = "Background: Red blood cell (RBC) transfusion remains an essential part of the management of patients with sickle cell disease (SCD). Alloimmunization is a major complication of transfusions. Extended RBC typing is advocated as a means to reduce alloimmunization in SCD. Our goal was to assess alloimmunization among individuals with SCD at our center since implementing extended RBC typing. Materials and Methods: We reviewed electronic medical records of all patients with SCD (N=641) in our comprehensive SCD Program to determine transfusion histories. Cross-referencing with our blood bank database, we extracted data such as antibodies identified, detection date and genotyping in specific cases. Transfusion sources were determined for those with C, E, and Kell antibodies. Results: Of 180 patients transfused from 2002 to 2011, 26 developed at least one new antibody. The majority of alloimmunized patients (14/26) received episodic transfusions only. The most common antibodies formed were against C and E antigens. Of the 16 patients who developed C, E, Kell antibodies, nine had one or more documented transfusions at an outside hospital. Five patients had Rh variants undetectable on routine phenotyping including two novel e alleles related to ceAR and ceS(733G). Conclusion: Despite extended RBC typing, alloimmunization may still occur due to RBC variants that are not detected on routine screening and transfusions at institutions where extended RBC typing is not done. Extended RBC typing should be the standard of care for patients with SCD. Prospective genotyping may reduce allosensitization to rare variants not detected on routine screening.",
keywords = "Alloimmunization, Extended red cell typing, Red cell transfusion, Sickle cell anemia",
author = "Chibuzo O'Suoji and Liem, {Robert I} and Mack, {Astrid Kyle} and Paris Kingsberry and Ramsey, {Glenn Eugene} and Thompson, {Alexis A}",
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Alloimmunization in sickle cell anemia in the era of extended red cell typing. / O'Suoji, Chibuzo; Liem, Robert I; Mack, Astrid Kyle; Kingsberry, Paris; Ramsey, Glenn Eugene; Thompson, Alexis A.

In: Pediatric Blood and Cancer, Vol. 60, No. 9, 01.09.2013, p. 1487-1491.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Alloimmunization in sickle cell anemia in the era of extended red cell typing

AU - O'Suoji, Chibuzo

AU - Liem, Robert I

AU - Mack, Astrid Kyle

AU - Kingsberry, Paris

AU - Ramsey, Glenn Eugene

AU - Thompson, Alexis A

PY - 2013/9/1

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N2 - Background: Red blood cell (RBC) transfusion remains an essential part of the management of patients with sickle cell disease (SCD). Alloimmunization is a major complication of transfusions. Extended RBC typing is advocated as a means to reduce alloimmunization in SCD. Our goal was to assess alloimmunization among individuals with SCD at our center since implementing extended RBC typing. Materials and Methods: We reviewed electronic medical records of all patients with SCD (N=641) in our comprehensive SCD Program to determine transfusion histories. Cross-referencing with our blood bank database, we extracted data such as antibodies identified, detection date and genotyping in specific cases. Transfusion sources were determined for those with C, E, and Kell antibodies. Results: Of 180 patients transfused from 2002 to 2011, 26 developed at least one new antibody. The majority of alloimmunized patients (14/26) received episodic transfusions only. The most common antibodies formed were against C and E antigens. Of the 16 patients who developed C, E, Kell antibodies, nine had one or more documented transfusions at an outside hospital. Five patients had Rh variants undetectable on routine phenotyping including two novel e alleles related to ceAR and ceS(733G). Conclusion: Despite extended RBC typing, alloimmunization may still occur due to RBC variants that are not detected on routine screening and transfusions at institutions where extended RBC typing is not done. Extended RBC typing should be the standard of care for patients with SCD. Prospective genotyping may reduce allosensitization to rare variants not detected on routine screening.

AB - Background: Red blood cell (RBC) transfusion remains an essential part of the management of patients with sickle cell disease (SCD). Alloimmunization is a major complication of transfusions. Extended RBC typing is advocated as a means to reduce alloimmunization in SCD. Our goal was to assess alloimmunization among individuals with SCD at our center since implementing extended RBC typing. Materials and Methods: We reviewed electronic medical records of all patients with SCD (N=641) in our comprehensive SCD Program to determine transfusion histories. Cross-referencing with our blood bank database, we extracted data such as antibodies identified, detection date and genotyping in specific cases. Transfusion sources were determined for those with C, E, and Kell antibodies. Results: Of 180 patients transfused from 2002 to 2011, 26 developed at least one new antibody. The majority of alloimmunized patients (14/26) received episodic transfusions only. The most common antibodies formed were against C and E antigens. Of the 16 patients who developed C, E, Kell antibodies, nine had one or more documented transfusions at an outside hospital. Five patients had Rh variants undetectable on routine phenotyping including two novel e alleles related to ceAR and ceS(733G). Conclusion: Despite extended RBC typing, alloimmunization may still occur due to RBC variants that are not detected on routine screening and transfusions at institutions where extended RBC typing is not done. Extended RBC typing should be the standard of care for patients with SCD. Prospective genotyping may reduce allosensitization to rare variants not detected on routine screening.

KW - Alloimmunization

KW - Extended red cell typing

KW - Red cell transfusion

KW - Sickle cell anemia

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