Red blood cell alloimmunisation in sickle cell disease patients in the Democratic Republic of the Congo

• Published in: Transfusion medicine (Oxford, England) Vol. 33; no. 2; pp. 137 - 146
• Main Authors: Kambale‐Kombi, Paul, Djang'eing'a, Roland Marini, Alworong'a Opara, Jean‐Pierre, Minon, Jean‐Marc, Sepulchre, Edith, Bours, Vincent, Floch, Aline, Pirenne, France, Tshilumba, Charles Kayembe, Batina‐Agasa, Salomon
• Format: Journal Article Web Resource
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.04.2023; Blackwell
• Subjects: Adolescent; Adult; Alloimmunisation; Anemia, Hemolytic, Autoimmune; Anemia, Sickle Cell - epidemiology; Anemia, Sickle Cell - therapy; Blood Group Antigens; Blood Transfusion; Child; Child, Preschool; Cross-Sectional Studies; Democratic Republic of the Congo - epidemiology; Erythrocytes; Hematology; Human health sciences; Humans; Hématologie; Isoantibodies; Prevalence; Sciences de la santé humaine; Sickle cell disease; Young Adult; Democratic Republic of the Congo; blood transfusion; prevalence; alloimmunisation; sickle cell disease
• ISSN: 0958-7578; 1365-3148; 1365-3148
• DOI: 10.1111/tme.12939

Objectives To determine the prevalence of red blood cell (RBC) alloimmunisation and alloantibody specificity in sickle cell disease (SCD) patients in Kisangani, Democratic Republic of Congo (DRC) in comparison with those followed at the Centre Hospitalier Régional (CHR) de la Citadelle of Liège (Belgium). Background Data regarding RBC alloimmunisation (immune response of the organism to foreign erythrocyte antigens, antigens that lack on its own RBC) in SCD patients are scarce in sub‐Saharan Africa. Methods We conducted a multi‐site‐based cross‐sectional study among 125 SCD patients at Kisangani and 136 at the CHR de la Citadelle of Liège. The diagnosis of SCD was confirmed by high‐performance liquid chromatography. Alloantibodies were screened using the agglutination technique on gel cards and their specificity determined using 11 and/or 16 cell panels. Statistical analyses were carried out using SPSS. Results The prevalence of RBC alloimmunisation was 9.6% among SCD patients in Kisangani versus 22.8% in those of Liège. At Kisangani as well as at Liège, the median age of alloimmunised patients was higher than that of non‐alloimmunised patients, 15.5 years (IQR:4.8–19.8) and 24 years (IQR:14–31) versus 10 years (IQR: 6.5–17) and 17 years (IQR:12–24), respectively. The median number of blood units was higher in both Kisangani and Liège immunised patients compared to non‐immunised patients, 8 (IQR:5–11) versus 5 (IQR:3–13) and 41(IQR:6–93) versus 6.5(3–37) respectively. At Kisangani (N = 14), the most frequent antibodies were anti‐D (28.6%) and anti‐C versus anti‐E (13.6%), anti‐S (13.6%) and anti‐Lea (11.4%) at Liège (N = 44). Conclusions These findings stated that alloimmunisation is a common complication in SCD patients in the DRC. In the resource‐limited setting of this country, blood transfusion with minimal ABO, D, C and E antigen matching in addition to the use of compatibility test could significantly reduce the incidence of this complication.