Alloimmunisation rates of sickle cell disease patients in the United States differ from those in other geographical regions

作者：Zheng Y; Maitta R W^*

来源：Transfusion Medicine, 2016, 26(3): 225-230.

DOI：10.1111/tme.12314

• red blood cell alloimmunisation
• sickle cell disease
• transfusion
• United States

ObjectivesComparison of the alloimmunisation rates of patients with sickle cell disease in the Unites States versus other countries.
BackgroundSickle cell disease (SCD) patients treated with chronic transfusion therapy are at a high risk of red blood cell (RBC) alloimmunisation.
Materials and MethodsWe reviewed published literature describing alloimmunisation rates of SCD patients. Average alloimmunisation rates and number of alloantibodies per transfused patient in the United States and other countries were evaluated.
ResultsTwenty-four studies on alloimmunisation of SCD patients were found, 15 studies with 3,708 patients in the US and 9 studies with 2203 patients from other regions, including South America, the Caribbean, Middle East, Africa and Europe. The United States has a higher alloimmunisation rate (2233013% versus 1625 +/- 035%, p<00001) and a higher number of alloantibodies per transfused patient (045 +/- 0003 versus 020 +/- 0005, p<00001) than other countries. Brazil with a higher proportion of multi-ethnic donors demonstrated a lower alloimmunisation rate compared to the United States (1460 +/- 040% versus 2233 +/- 013%, p<00001) and fewer alloantibodies per transfused patient (020 +/- 002 versus 045 +/- 0003, p<00001) than the United States.
ConclusionSCD patients in the United States had a higher alloimmunisation rate, which could be reduced by a more ethnically diverse donor pool and a more conservative transfusion strategy in non-critical conditions.

• 出版日期2016-6