Original ResearchImpact of Red Blood Cell Antigen Matching on Alloimmunization and Transfusion Complications in Patients with Sickle Cell Disease: A Systematic Review
Section snippets
Methods
The study team was comprised of two hematology-oncology specialists in SCD (one pediatric, RF, and one adult, JE), two transfusion medicine specialists (EM, RF) and individuals with expertise is systematic review methodology (RG, JB), including an academic medical reference librarian (MW) who designed and conducted the database searches and validated them with two study team members (EM, JE).
The PRISMA Statement guided the process of data identification and screening, determination of
Results of the Search
Figure 1 summarizes the results of the systematic search and review process. Searches of the PubMed, Embase, Cochrane, and Web of Science databases yielded 269 unique references. Reference searches of articles given full review from these sources produced an additional 27 articles, with another seven identified by word of mouth or Google Scholar Alerts for a total 303 unique references. Sixteen references for books or book chapters, letters, editorials, reviews or unavailable in English were
Discussion
Many individuals with SCD require frequent acute transfusions for symptomatic anemia and acute SCD-related complications and can be on chronic transfusions for prevention of stroke, acute chest syndrome, and other complications. Present evidence suggests that secondary stroke prevention requires lifelong transfusion and only a proportion of patients may be successfully transitioned off chronic transfusions for primary stroke prevention [32], [33]. However, alloimmunization and subsequent DHTRs
Summary and Conclusions
Transfusions play an important role in managing and preventing complications in SCD. As a result, individuals with SCD have a high prevalence of alloimmunization which contributes to increased risks for DHTRs, resulting in increased complexity and cost of management. A number of strong recommendations have been made by expert panels to reduce alloimmunization rates and improve management of alloimmunized individuals. However, the quality and amount of evidence supporting these recommendations
Conflict of Interest
RMF has served as an advisory board member for Immucor (PreciseType HEA). EKM has no conflicts. JB has no conflicts. MSW has no conflicts. RWG has no conflicts. JRE has no conflicts.
Support
This work was supported by Cooperative Agreement 5 NU58 DD001138-03, funded by the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the CDC or the Department of Health and Human Services.
References (39)
- et al.
Transfusion and alloimmunization in sickle cell disease. The Cooperative Study of Sickle Cell Disease
Blood
(1990) - et al.
High prevalence of red blood cell alloimmunization in sickle cell disease despite transfusion from Rh-matched minority donors
Blood
(2013) - et al.
The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies
J Clin Epidemiol
(2008) - et al.
Hydroxycarbamide versus chronic transfusion for maintenance of transcranial doppler flow velocities in children with sickle cell anaemia-TCD With Transfusions Changing to Hydroxyurea (TWiTCH): a multicentre, open-label, phase 3, non-inferiority trial
Lancet
(2016) - et al.
Guidelines on red cell transfusion in sickle cell disease. Part I: principles and laboratory aspects
Br J Haematol
(2017) - et al.
Guidelines on red cell transfusion in sickle cell disease Part II: indications for transfusion
Br J Haematol
(2017) Management of Sickle Cell Disease: Summary of the 2014 Evidence-Based Report by Expert Panel Members (vol 312, pg 1033, 2014)
JAMA
(2014)- et al.
Post-transfusion alloimmunization in patients with sickle cell disease
Am J Hematol
(1978) - et al.
Red cell alloimmunization in sickle cell disease
Br J Haematol
(1986) - et al.
Experience with donors matched for minor blood group antigens in patients with sickle cell anemia who are receiving chronic transfusion therapy
Transfusion
(1987)
Alloimmunization in sickle cell anemia and transfusion of racially unmatched blood
N Engl J Med
Genotyping Applications for Transplantation and Transfusion Management: The Emory Experience
Arch Pathol Lab Med
Variant RH alleles and Rh immunisation in patients with sickle cell disease
Blood Transfus
Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement
Ann Intern Med
The Oxford Levels of Evidence 2
Explanation of the 2011 Oxford Centre for Evidence-Based Medicine (OCEBM) Levels of Evidence (Background Document)
Cost-effectiveness of prospective red blood cell antigen matching to prevent alloimmunization among sickle cell patients
Transfusion
Multiple transfusions for sickle cell disease in the Democratic Republic of Congo: The importance of the hepatitis C virus
Transfus Clin Biol
Red blood cell alloimmunization among sickle cell Kuwaiti Arab patients who received red blood cell transfusion
Transfusion
Cited by (45)
How I treat sickle cell disease in pregnancy
2024, BloodEffects of prophylactic red blood cell (RBC) transfusion with extended antigen matching on alloimmunization in patients with Sickle Cell Disease (SCD)
2023, Transfusion and Apheresis Science
- 1
These authors are joint first authors on this work.