Alloimmunization after blood transfusion in patients with hematooncologic diseases in southern Taiwan

The development of erythrocyte alloantibodies complicates transfusion therapy in patients with chronic transfusion. Because of intensive marrow depression and improved survival, patients with hematologic and oncologic malignancies are dependent on transfusion for a longer period. However, no data are available on the frequency of erythrocyte alloimmunization in patients with hematooncologic diseases in Taiwan. We analysed the clinical and transfusion records of all patient (n=636) with malignant myeloproliferative and lymphproliferative diseases diagnosed between 2007 and 2011 at Chi-Mei hospital, Tainan, Taiwan, a tertiary teaching hospital. Of Patients who never received a transfusion, who had autoantibodies, who had antibodies that were present before the study began and those who did not undergo at least one antibody screening after the first blood transfusion were excluded. This left 369 evaluable patients. Of the 369 patients, 26 (7%) were found to carry alloantibodies. The median age at diagnosis was 67 years (range 20-86 years), and the male- to-female ratio was 1.2. The total number of units transfused per patients before alloimmunization ranged from 2 to 35, with a median of 8 units. Gender and age had no influence on the rate of antibody formation. All alloantibodies were clinically significant specificities, including two of anti-‘Mia’+ E , four of anti-E + c, eight of anti-‘Mia’, eight of anti-E, one of anti-C+e, one of anti-Jkb, one of anti-Lea and one of anti-Dia. Alloimmunization to erythrocyte antigens is not a frequent complication in hematooncologic diseases. This probably due to patients with hematological disease is usually undergoing immunosuppressive treatment and intensive chemotherapy. No difficulty was encountered in finding compatible blood for these patients. Extensive antigen matching before transfusion of patients with hematologic and oncologic malignancies seems not necessary and leads to increased costs.