Spanos T, Karageorga M, Ladis V, Peristeri J, Hatziliami A, Kattamis C
Blood Transfusion Center, Faculty of Medicine at Aghia Sophia Children's Hospital, Athens, Greece.
Vox Sang. 1990;58(1):50-5. doi: 10.1111/j.1423-0410.1990.tb02055.x.
We present the results of tests carried out to detect alloimmunization against red cells in 1,200 patients (607 males and 593 females), transfused and followed up during the period 1981-1987 in our hospital. Of these patients, 1,135 were thalassemic and 65 had sickle cell/beta-thalassemia. In 162 patients who received blood matched for the AB0, rhesus and Kell systems from their first transfusion, the immunization rate was very low (3.7%). In a pilot group consisting of 83 patients with the same clinical characteristics, who received blood matched only for the AB0 and Rh-D antigens, there was a significant difference in the frequency of alloantibodies (15.7%, p less than 0.001). Of 1,038 patients who received blood only matched for AB0 and Rh-D 244 (23.5%) with one or more red cell alloantibodies were identified. Of these 1,038 patients, 973 were exclusively thalassemic. In 220 (22.6%) of them, alloantibodies were found. The sickle cell beta-thalassemia patients presented alloantibodies with a higher frequency (36.9%, 24/65). Only one antibody was found in 114 patients (51.8%) and two or more in 106 patients (48.2%). The alloimmunization significantly concerned the rhesus (34.0%) and Kell (29.8%) systems. Anti-Kell was most often identified (28.5%). Alloimmunization appears considerably lower in patients in whom blood transfusion is started before the age of 3 than in those in whom it is started after that age (20.9 vs. 47.5%, p less than 0.0001).
我们展示了对1200名患者（607名男性和593名女性）进行的检测结果，这些患者于1981年至1987年期间在我院接受输血并进行随访，以检测其针对红细胞的同种免疫情况。在这些患者中，1135例为地中海贫血患者，65例为镰状细胞/β地中海贫血患者。在162例首次输血时接受AB0、恒河猴和凯尔系统血型匹配血液的患者中，免疫率非常低（3.7%）。在一个由83例具有相同临床特征、仅接受AB0和Rh-D抗原血型匹配血液的患者组成的试验组中，同种抗体的频率存在显著差异（15.7%，p<0.001）。在1038例仅接受AB0和Rh-D血型匹配血液的患者中，有244例（23.5%）被鉴定出有一种或多种红细胞同种抗体。在这1038例患者中，973例仅为地中海贫血患者。其中220例（22.6%）发现了同种抗体。镰状细胞β地中海贫血患者出现同种抗体的频率更高（36.9%，24/65）。114例患者（51.8%）仅发现一种抗体，106例患者（48.2%）发现两种或更多种抗体。同种免疫主要涉及恒河猴系统（34.0%）和凯尔系统（29.8%）。抗凯尔抗体最常被鉴定出（28.5%）。3岁前开始输血的患者同种免疫发生率似乎比3岁后开始输血的患者低得多（20.9%对47.5%，p<0.0001）。
