Irregular antibodies in paediatric haematological disorders: Prevalence and characteristics from a Vietnamese tertiary centre.

BACKGROUND AND

OBJECTIVES

Paediatric patients with haematological disorders frequently require multiple blood transfusions, increasing their risk of developing irregular antibodies. Because of the immunohaematological differences from adults, patterns of alloimmunization in children may vary. This study aimed to determine the prevalence and characteristics of irregular antibodies in paediatric patients with haematological disorders at the National Institute of Hematology and Blood Transfusion (NIHBT).

MATERIALS AND

METHODS

A total of 2663 paediatric patients with haematological disorders were screened for irregular antibodies using column agglutination technology. Positive samples underwent antibody identification. Associations between alloimmunization and clinical or transfusion-related factors were assessed using univariate analyses and multivariable logistic regression.

RESULTS

The prevalence of irregular antibodies was 8.04% (95% confidence interval [CI]: 7.0-9.1). Among positive cases, 66.82% had a single antibody, most commonly anti-E (35.51%) and anti-Mia (14.02%). The most frequent antibody combination was anti-c and anti-E (13.08%). Factors significantly associated with antibody formation after adjustment included a higher number of transfused red cell units (57.65 vs. 44.53 units, p = 0.000), absence of phenotype-matched transfusions (p = 0.017), non-Kinh ethnicity (p = 0.0003) and a diagnosis of thalassaemia (p = 0.0013).

CONCLUSION

A relatively high prevalence of irregular red cell alloantibodies was observed in paediatric patients, predominantly involving antibodies of the Rh blood group system and anti-Miᵃ. These findings support the relevance of targeted antigen matching in settings where fully phenotype-matched red blood cells are not consistently available.