This publication was made possible by Grant U10HL083721 from the National Heart, Lung, and Blood Institute, National Institutes of Health. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health.
Red blood cell alloimmunization in sickle cell disease: prevalence in 2010
Article first published online: 13 JUL 2012
© 2012 American Association of Blood Banks
Volume 53, Issue 4, pages 704–709, April 2013
How to Cite
Miller, S. T., Kim, H.-Y., Weiner, D. L., Wager, C. G., Gallagher, D., Styles, L. A., Dampier, C. D., Roseff, S. D. and Investigators of the Sickle Cell Disease Clinical Research Network (SCDCRN) (2013), Red blood cell alloimmunization in sickle cell disease: prevalence in 2010. Transfusion, 53: 704–709. doi: 10.1111/j.1537-2995.2012.03796.x
- Issue published online: 8 APR 2013
- Article first published online: 13 JUL 2012
- Received for publication March 18, 2012; revision received May 31, 2012, and accepted June 4, 2012.
BACKGROUND: Transfusion of red blood cells (RBCs) is frequently required for care of individuals with sickle cell disease (SCD). Alloimmunization rates are high and may be reduced by matching for RBC antigens that can cause alloimmunization.
STUDY DESIGN AND METHODS: During the PROACTIVE Feasibility Study, patients with SCD age 2 years or older admitted for pain without acute chest syndrome were enrolled for possible randomization to preventive blood transfusion or standard care. Transfusion and antibody histories were obtained at each site, and antibody screening was done, to assess transfusion burden and alloimmunization prevalence. Participating sites were surveyed regarding antigen matching practice.
RESULTS: A total of 237 patients (169 SS, 42 SC, 15 Sβ0-thalassemia, 11 Sβ+-thalassemia), 118 males and 119 females, were enrolled. Mean age was 19.3 years (range, 2.0-68.0); there were 122 children and 115 adults. A total of 75.8% had received at least a single transfusion of RBCs before the study. Thirty-four patients (14.4%) had a history of at least one alloantibody and 17 of these had more than one. When surveyed, 19 sites (83% of responders) reported antigen matching to at least include C, E, and K for transfusion of all patients with SCD.
CONCLUSION: Though antigen typing before transfusion of people with SCD and providing antigen-negative units is now widely employed by sickle cell centers, the alloimmunization rate remains quite high in contemporary sickle cell populations and may be due in large part to transfusions received at institutions not providing extended matching.