Red blood cell alloimmunization in Iranian beta-thalassemia patients: a systematic review and meta-analysis

• Published in: ISBT science series Vol. 11; no. 3; pp. 163 - 173
• Main Authors: Darvishi, Parisa, Azami, Milad, Sayehmiri, Kourosh, Sayehmiri, Fatemeh, Goodarzi, Alireza, Azarkeivan, Azita, Pourfathollah, Ali Akbar
• Format: Journal Article
• Language: English
• Published: Oxford Blackwell Publishing Ltd 01.12.2016; Wiley Subscription Services, Inc
• Subjects: alloimmunization; blood group system; Erythrocytes; Iran; meta-analysis; thalassaemia
• ISSN: 1751-2816; 1751-2824
• DOI: 10.1111/voxs.12299

Background and Objectives Red blood cell alloimmunization is associated with haemolytic reactions and severe clinical consequences. The rate of alloimmunization in multitransfused patients such as thalassaemia is high that is a major challenge. The present meta‐analysis study was conducted to determine the prevalence of alloimmunization in Iranian thalassaemia patients. Materials and Methods This study was conducted based on the computerized literature database. English and non‐English articles were searched from 1994 to 2015. Alloimmunization rates and 95% CI calculated by random‐effect model. Statistical analysis was performed using Stata 11.2, and ArcGIS 10.3 was used for map construction. Results Eighteen papers from 297 studies involving 4677 patients met our inclusion criteria. The prevalence of alloimmunization in Iranian thalassaemia was 10%(CI 95%: 7–13). The most prevalent alloantibody was anti‐K (37%), followed by anti‐D (29%) and anti‐E (20%) in the country. Conclusion The prevalence of alloimmunization among Iranian thalassaemia has not been decreased from 1994 to 2013. In spite of detecting D antigen in pretransfusion test, the rate of anti‐D is high in our population. It shows the importance of more investigation on data on D variants. Although the rate of alloimmunization is low in Iran comparing to many other countries, there is a need to adopt some strategies to reduce alloimmunization.