Kambale-Kombi Paul, Djang'eing'a Roland Marini, Alworong'a Opara Jean-Pierre, Minon Jean-Marc, Sepulchre Edith, Bours Vincent, Floch Aline, Pirenne France, Tshilumba Charles Kayembe, Batina-Agasa Salomon
Département de Médecine interne, Faculté de Médecine et de Pharmacie, Université de Kisangani, Kisangani, Democratic Republic of the Congo.
Département des Sciences Pharmaceutiques, Laboratoire de chimie analytique, Faculté de Médecine, Université de Liège, Liège, Belgium.
Transfus Med. 2023 Apr;33(2):137-146. doi: 10.1111/tme.12939. Epub 2022 Nov 15.
To determine the prevalence of red blood cell (RBC) alloimmunisation and alloantibody specificity in sickle cell disease (SCD) patients in Kisangani, Democratic Republic of Congo (DRC) in comparison with those followed at the Centre Hospitalier Régional (CHR) de la Citadelle of Liège (Belgium).
Data regarding RBC alloimmunisation (immune response of the organism to foreign erythrocyte antigens, antigens that lack on its own RBC) in SCD patients are scarce in sub-Saharan Africa.
We conducted a multi-site-based cross-sectional study among 125 SCD patients at Kisangani and 136 at the CHR de la Citadelle of Liège. The diagnosis of SCD was confirmed by high-performance liquid chromatography. Alloantibodies were screened using the agglutination technique on gel cards and their specificity determined using 11 and/or 16 cell panels. Statistical analyses were carried out using SPSS.
The prevalence of RBC alloimmunisation was 9.6% among SCD patients in Kisangani versus 22.8% in those of Liège. At Kisangani as well as at Liège, the median age of alloimmunised patients was higher than that of non-alloimmunised patients, 15.5 years (IQR:4.8-19.8) and 24 years (IQR:14-31) versus 10 years (IQR: 6.5-17) and 17 years (IQR:12-24), respectively. The median number of blood units was higher in both Kisangani and Liège immunised patients compared to non-immunised patients, 8 (IQR:5-11) versus 5 (IQR:3-13) and 41(IQR:6-93) versus 6.5(3-37) respectively. At Kisangani (N = 14), the most frequent antibodies were anti-D (28.6%) and anti-C versus anti-E (13.6%), anti-S (13.6%) and anti-Lea (11.4%) at Liège (N = 44).
These findings stated that alloimmunisation is a common complication in SCD patients in the DRC. In the resource-limited setting of this country, blood transfusion with minimal ABO, D, C and E antigen matching in addition to the use of compatibility test could significantly reduce the incidence of this complication.
确定刚果民主共和国基桑加尼镰状细胞病（SCD）患者中红细胞（RBC）同种免疫和同种抗体特异性的患病率，并与比利时列日市城堡地区中心医院（CHR）所跟踪的患者进行比较。
撒哈拉以南非洲地区关于SCD患者红细胞同种免疫（机体对外来红细胞抗原的免疫反应，自身红细胞缺乏的抗原）的数据很少。
我们在基桑加尼的125例SCD患者和列日市城堡地区中心医院的136例患者中开展了一项多中心横断面研究。通过高效液相色谱法确诊SCD。使用凝胶卡上的凝集技术筛查同种抗体，并使用11和/或16细胞板确定其特异性。使用SPSS进行统计分析。
基桑加尼SCD患者中红细胞同种免疫的患病率为9.6%，而列日市患者为22.8%。在基桑加尼和列日市，同种免疫患者的年龄中位数均高于未同种免疫患者，分别为15.5岁（四分位间距：4.8 - 19.8）和24岁（四分位间距：14 - 31），而未同种免疫患者分别为10岁（四分位间距：6.5 - 17）和17岁（四分位间距：12 - 24）。与未免疫患者相比，基桑加尼和列日市免疫患者的输血单位中位数均更高，分别为8（四分位间距：5 - 11）和5（四分位间距：3 - 13），以及41（四分位间距：6 - 93）和6.5（3 - 37）。在基桑加尼（n = 14），最常见的抗体是抗-D（28.6%）和抗-C，而在列日市（n = 44）是抗-E（13.6%）、抗-S（13.6%）和抗-Lea（11.4%）。
这些研究结果表明，同种免疫是刚果民主共和国SCD患者的常见并发症。在该国资源有限的情况下，除了使用相容性检测外，进行ABO、D、C和E抗原匹配最少的输血可显著降低这种并发症的发生率。
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