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Red Cell Alloimmunization and Autoimmunization in Multi-Transfused Thalassemia Patients in Sulaymaniyah Province-Iraq
Korean J Clin Lab Sci 2020;52:98-104  
Published on June 30, 2020
Copyright © 2020 Korean Society for Clinical Laboratory Science.

Aveen M. Raouf Abdulqader1, Ali Ibrahim Mohammed1, Nagham Ibrahim Mohammed2

1Department of Pathology, College of Medicine, University of Sulaymaniyah, Sulaymaniyah, Iraq
2Ninavah Health Directorate, Ninavah, Iraq
Correspondence to: Aveen M. Raouf Abdulqader
Department of Pathology, College of Medicine, University of Sulaymaniyah, Fransometeran Road, Sulaymaniyah, Kurdistan 46001, Iraq
E-mail: aveenm80@yahoo.com
ORCID: https://orcid.org/0000-0002-4301-6470
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Thalassemias are considered important health issues throughout Iraq, involving its Kurdistan region. This disorder, particularly its major form, needs lifelong regular transfusions. But this form of medical care is associated with various complications including red cell alloimmunization and autoimmunization. This study determined the frequency and associations of alloimmunization among multi-transfused patients with β-thalassemia major. The subjects were 204 patients who were registered at a thalassemia care center in Sulaymaniyah-Iraqi Kurdistan. The patients’ records were analyzed, their red cells were phenotyped for ABO/RhD antigens using the gel card method, and irregular antibody screening/identification was performed using the standard tube method. Alloantibodies were detected in 5.8% of the patients, while DAT was positive in 4% of the patients, which indicated autoantibodies. The identified alloantibodies were anti-E (2.4%), anti-C (1.4%), anti-e (1%), and anti-K (1%). A patient’s age at the start of transfusion (>2 years) (P=0.042) and a positive history of transfusion reactions (P=0.003) were correlated with a significantly higher rate of alloantibody formation. From the results of our study, we conclude that measures to decrease the development of alloantibodies may incorporate matching for Rhesus and Kell systems and early induction of blood transfusions.
Keywords : Alloimmunization, Autoimmunization, β-thalassemia major, Sulaymaniyah, Kurdistan

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