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首页> 外文期刊>African Journal of Laboratory Medicine >Red cell allo- and autoimmunisation in transfused sickle cell and cancer patients in Kenyatta National Hospital, Nairobi, Kenya
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Red cell allo- and autoimmunisation in transfused sickle cell and cancer patients in Kenyatta National Hospital, Nairobi, Kenya

机译：肯尼亚内罗毕肯雅塔国家医院输血的镰状细胞和癌症患者的红细胞同种免疫和自身免疫

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Background: Currently, no data are available on the prevalence of red blood cell (RBC) antibody formation amongst Kenyan patients with multiple transfusion needs, such as patients with sickle cell disease (SCD) or haematological malignancies (HM) and solid (SM) malignancies.Objectives: We determined the prevalence and specificities of RBC alloantibodies and autoantibodies in two patient groups with recurrent transfusion demands at Kenyatta National Hospital, Nairobi, Kenya.Method: Between February and August 2014, 300 samples from SCD, HM and SM patients were collected and screened for alloantibodies. Samples from 51 healthy blood donors were screened for irregular antibodies and phenotyped.Results: Amongst the 228 patients with viable samples (SCD, n = 137; HM, n = 48; SM, n = 43), the median transfusion frequency was two to three events per group, 38 (16.7%) were RBC immunised and 32 (14.0%) had a positive direct antiglobulin test. We identified specific alloantibodies in six patients (2.6%). Four of these six were SCD patients (2.9%) who had specific RBC alloantibodies (anti-Cw, anti-M, anti-Cob, anti-S); amongst HM patients one had anti-K and one had anti-Lea. RBC autoantibody prevalence was 3.1% (7/228). Amongst the healthy blood donors, the Ror, ccD.ee and R2r, ccD.Ee phenotypes accounted for 82% of the Rhesus phenotypes and all were Kell negative.Conclusion: The numbers of transfusions and the rates of RBC alloantibodies are low and the most important RBC alloantibody-inducing blood group antigens are relatively homogeneously distributed in this population. A general change in the Kenyatta National Hospital pre-transfusion test regimen is thus not necessary. The current transfusion practice should be reconsidered if transfusion frequencies increase in the future.
机译：背景：目前，尚无关于需要多次输血的肯尼亚患者（例如镰状细胞病（SCD）或血液系统恶性肿瘤（HM）和实体性（SM）恶性肿瘤患者）中红细胞（RBC）抗体形成率的数据。目的：我们在肯尼亚内罗毕的肯雅塔国家医院确定了两个有反复输血需求的患者群体中红细胞同种抗体和自身抗体的患病率和特异性。方法：2014年2月至2014年8月，从SCD，HM和SM患者中收集了300个样本并筛选同种抗体。结果：在228例有活检的患者中（SCD，n = 137; HM，n = 48; SM，n = 43），对51名健康献血者的样本进行了筛查和表型分析。每组3个事件，其中RBC免疫了38（16.7％），直接抗球蛋白测试阳性32（14.0％）。我们在六名患者（2.6％）中发现了特异性同种抗体。这六名患者中有四名是SCD患者（2.9％），他们具有特定的RBC同种抗体（抗C w ，抗M，抗Co b ，抗S）;在HM患者中，一名患有抗K病，一名患有抗Le a 。红细胞自身抗体患病率为3.1％（7/228）。在健康献血者中，R o r，ccD.ee和R 2 r，ccD.Ee表型占恒河猴表型的82％，且均为Kell阴性。结论：输血次数和红细胞同种抗体的发生率低，最重要的诱导红细胞同种抗体的血型抗原在该人群中相对均匀分布。因此，无需对肯尼亚肯塔塔国家医院的输血前测试方案进行总体更改。如果将来输血频率增加，应重新考虑当前的输血方式。

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