Analysis of risk factors for red blood cell alloimmunization and its incidence in hemoglobinopathy patients at a tertiary care center in Odisha, Eastern India.

BACKGROUND

Sickle cell disease (SCD) and thalassemia are common hemoglobinopathies in Eastern India. Regular blood transfusion in these patients leads to alloimmunization. Finding compatible red blood cell units remain a challenge in these patients delaying the transfusion support.

AIMS: This study aims to estimate the frequency of alloimmunization and predicts the associated risk factors.

METHODOLOGY: A retrospective study was conducted for 2 years. Data were retrieved from the immunohematology work-up record. The Chi-square statistics determined the risk factors associated with alloimmunization. Multivariate regression analysis was used to identify independent risk factors of alloimmunization, adjusting the confounders. A P < 0.05 was considered as statistically significant.

RESULTS

Forty-seven patients out of 132 developed antibodies. Of these, 41 presented with only alloantibodies, three patients had only autoantibodies, and the rest 3 had both autoantibodies and alloantibodies. Most commonly observed alloantibodies were against Rh, Kidd, Duffy, and S antigens. SCD appeared a significant risk factor for the development of alloimmunization in the Chi-square test (P = 0.003). However, multivariate analysis revealed only age of more than 2 years at the first transfusion, and up to ten transfusions are independent risk factors of alloimmunization (P < 0.05).

CONCLUSION

We found a high incidence of alloimmunization in multitransfused hemoglobinopathies patients in this region. This study also shows the first transfusion at an age of more than 2 years and up to 10 transfusions are independent predictors of alloimmunization.