Prevalence of Alloimmunization to Human Platelet Antigen Glycoproteins and Human Leucocyte Antigen Class I in β Thalassemia Major Patients in Western India
Prevalence of Alloimmunization to Human Platelet Antigen Glycoproteins and Human Leucocyte Antigen Class I in β Thalassemia Major Patients in Western India
复制标题
印度西部重型 β 地中海贫血患者对人血小板抗原糖蛋白和人白细胞抗原 I 类同种免疫的流行率
DOI：
10.1007/s12288-013-0297-5
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发表时间：
2014
影响因子：
0.9
通讯作者：
R. S. Mallhi
中科院分区：
文献类型：
--
作者：
J. Philip;Sudeep Kumar;T. Chatterjee;R. S. Mallhi
目前对重型β地中海贫血的治疗不仅对红细胞抗原，而且对人类血小板抗原(HPA)和人类白细胞抗原I类(HLAI)都存在同种异体免疫的风险。然而，这方面的数据在印度人口中非常有限。本研究的目的是确定多年来接受多次输血的重型β地中海贫血患者对HPA和HLAI的同种异体免疫的发生率。在我们的三级护理血库进行了一项横断面研究。β地中海贫血主要患者年龄在6岁以上，定期接受新鲜的、去白细胞的和照射的PRBC单位，每年需要10次以上的PRBC输血。在80例患者中，共有9例(11.25%)被发现对各种特异性的HPA抗原进行了同种异基因免疫，而在80例患者中，有24例(30%)产生了对HPA和HLAI的抗体。意识到尽管使用了白细胞滤器，但在多红细胞输血的地中海贫血中出现了对HPA和HLA抗原的同种免疫，这将促使我们在目前的PRBC制备方法中寻找改进，以最大限度地减少血小板同种免疫。还需要进一步研究，以验证调查结果并建立这方面的基线数据。这一点很重要，特别是考虑到未来需要时提供合适的交叉匹配的血小板，特别是在考虑未来的造血干细胞移植(HSCT)时。
Present management of β thalassemia major by regular packed red blood cell (PRBC) transfusions poses risk of alloimmunization not only to red blood cell antigens, but also to human platelet antigens (HPA) and Human leucocyte antigens class I (HLA I). However data in this context is very limited in Indian population. The aim of the study was to determine the prevalence of alloimmunization to HPA and HLA I in β thalassemia major patients who have received multiple PRBC transfusions over the years. A cross sectional study was performed at our tertiary care blood bank. β thalassemia major patients of more than 6 years of age were included who were receiving fresh, leucoreduced and irradiated PRBC units regularly with annual requirement of more than ten PRBC transfusions. A total of 9 out of 80 (11.25 %) patients were found to be alloimmunized for HPA antigens of various specificity and 24 out of 80 (30 %) developed antibodies to HLA I. The awareness of development of alloimmunization to HPA and HLA antigens in multi PRBC transfused thalassemics, despite use of leucofilters will prompt us, to look for improvement in our current PRBC preparations to minimise platelet alloimmunisation. Further studies are required to validate the findings and build the base line data in this regard. This is of importance, especially in view of providing suitable cross-matched platelets when required in future especially when considering future haematopoietic stem cell transplantation (HSCT).