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SUMMARY Background One of the biggest concerns in transfusion medicine is to avoid red blood cell alloimmunization. We evaluated the rate of alloimmunization in two groups of chronically transfused patients (A - not phenotyped and B - phenotyped for Rh/K antigens before the first transfusion) with primary haematological disorders and its distribution among the main haematological diseases, in order to adopt an efficient transfusional strategy. Study design and methods As methodology, we used the SIBAS and SAM databases for the retrospective study of all patients with primary haematological disorder between January 2011 and April 2013. Results A statistical difference in the rate of alloimmunization comparing groups A and B was found ( P <0·0001). We also observed that alloimmunization was not homogeneously distributed in all primary haematological diseases. Conclusions The Rh/K phenotype should be performed on all patients diagnosed with bone marrow failure, plasma cell dyscrasia and myelodysplastic syndrome in order to avoid alloimmunization. In patients with acute leukaemia and lymphoma it seems not necessary to perform it. In patients with haemoglobinopathy and myeloproliferative disorders, a larger group of patients is needed to decide its efficacy. [ABSTRACT FROM AUTHOR]