Red blood cell alloimmunization in sickle cell disease and in thalassaemia: current status, future perspectives and potential role of molecular typing

• Published in: Vox sanguinis Vol. 106; no. 3; pp. 197 - 208
• Main Authors: Matteocci, A., Pierelli, L.
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.04.2014; S. Karger AG
• Subjects: Anemia, Sickle Cell - blood; Anemia, Sickle Cell - immunology; Anemia, Sickle Cell - therapy; Antigens; Blood Group Incompatibility - blood; Blood Group Incompatibility - complications; Blood Group Incompatibility - immunology; Blood Grouping and Crossmatching - methods; Blood Grouping and Crossmatching - standards; Blood Grouping and Crossmatching - trends; blood groups; Blood Transfusion - standards; Blood Transfusion - trends; Blood transfusions; Erythrocytes; Forecasting; genotyping; Humans; Immunization, Passive - trends; immunohaematology; Isoantibodies - biosynthesis; Isoantibodies - blood; Molecular biology; RBC antigens and antibodies; Risk Factors; Sickle cell disease; Thalassemia - blood; Thalassemia - immunology; Thalassemia - therapy; Transfusion Reaction; transfusion strategy; transfusion strategy; blood groups; RBC antigens and antibodies; immunohaematology; genotyping
• ISSN: 0042-9007; 1423-0410; 1423-0410
• DOI: 10.1111/vox.12086

Red blood cell (RBC) transfusions are a milestone in the treatment for sickle cell anaemia (SSA) and for thalassaemia. RBC alloimmunization remains a major challenge of chronic transfusion therapy, and it can lead to adverse life‐threatening events. The alloimmunization risk could depend on multiple factors such as the number of transfusions and, most of all, the genetic background. Different ethnic groups are predisposed to immunization because of a significant degree of RBC antigenic mismatch between donor and recipient. There is no universal agreement and standards for the most appropriate selection of RBC units in chronically transfused subjects. Current practice only deals with compatibility of ABO, Rh and K antigens. Molecular RBC antigenic matching extended to other blood group systems is an innovative strategy to ensure a better quality and effectiveness of transfusion therapy.