Study of Alloimmunization in Transfusion‑dependent Thalassemia Patients at a Tertiary Care Hospital.

BACKGROUND: Alloantibodies against donor red blood cells (RBCs) are developed by patients with transfusion‑dependent thalassemia (TDT), which causes the donor RBCs to hemolyze. This decreases the transfusion’s efficacy and increases the risk of adverse effects like iron overload. MATERIALS AND METHODS: Two hundred and five TDT patients with an average age of 11 ± 6 years enrolled in this study underwent the Direct Coombs Test (DCT) to determine the frequency of alloimmunization. RESULTS: Most cases were of thalassemia major (TM) (76.09%), followed by thalassemia intermedia (TI) and (21.95%). Most of the cases were diagnosed and started on regular blood transfusion therapy between the ages of 1 and 10 years. Majority of the cases were born of parental consanguinity. Only 13.17% of the patients underwent splenectomy, of which TM cases were the majority. Even though O‑positive was the most frequent blood type, most of the operated and alloimmunized cases belonged to the B‑positive blood type. Only 10.24% of the patients had alloimmunization, with 51.85% of them developing it after splenectomy. Among all study participants, no correlation was found between the blood group and the type of thalassemia, alloimmunization, or splenectomy. Among TDT cases, there was a significant correlation (P < 0.0001) between alloimmunization and splenectomy. Alloimmunization and splenectomy correlated significantly with the total number of transfusions, the volume of blood transfused, and the transfusion initiation age. CONCLUSION: Our findings emphasize the significance of antigen typing in TDT patients before the first transfusion. [ABSTRACT FROM AUTHOR]