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Irregular antibodies in paediatric haematological disorders: Prevalence and characteristics from a Vietnamese
Tung Quang Nguyen1,2,3, Nga Thanh Thi Hoang4, Hong Thi Hoang1,5
1Department of Hematology and Blood Transfusion, Hanoi Medical University, Hanoi, Vietnam.
Insights
Children with blood disorders often develop irregular antibodies after transfusions. This study found an 8.04% prevalence, with anti-E and anti-Miª being most common, highlighting the need for antigen matching in paediatric transfusions.
Area of Science:
- Immunohaematology
- Paediatric Haematology
- Transfusion Medicine
Background:
- Paediatric patients with haematological disorders often require multiple transfusions.
- Multiple transfusions increase the risk of developing irregular antibodies.
- Alloimmunization patterns in children may differ from adults due to immunohaematological variations.
Purpose of the Study:
- To determine the prevalence and characteristics of irregular antibodies in paediatric patients with haematological disorders.
- To identify factors associated with alloimmunization in this population.
- To inform transfusion strategies for paediatric patients.
Main Methods:
- Screening of 2663 paediatric patients with haematological disorders for irregular antibodies using column agglutination technology.
- Antibody identification for positive samples.
- Univariate and multivariable logistic regression analyses to assess associations between alloimmunization and clinical/transfusion factors.
Main Results:
- Prevalence of irregular antibodies was 8.04%.
- Most common antibodies included anti-E (35.51%) and anti-Miª (14.02%).
- Significant factors associated with antibody formation included higher transfusion volume, absence of phenotype matching, non-Kinh ethnicity, and thalassaemia diagnosis.
Conclusions:
- A significant prevalence of irregular red cell alloantibodies was observed in paediatric patients.
- Antibodies primarily involved the Rh blood group system and anti-Miª.
- Findings underscore the importance of antigen matching for red blood cell transfusions in children, especially when fully matched units are unavailable.
Background And Objectives:
Paediatric patients with haematological disorders frequently require multiple blood transfusions, increasing their risk of developing irregular antibodies. Because of the immunohaematological differences from adults, patterns of alloimmunization in children may vary. This study aimed to determine the prevalence and characteristics of irregular antibodies in paediatric patients with haematological disorders at the National Institute of Hematology and Blood Transfusion (NIHBT).
Materials And Methods:
A total of 2663 paediatric patients with haematological disorders were screened for irregular antibodies using column agglutination technology. Positive samples underwent antibody identification. Associations between alloimmunization and clinical or transfusion-related factors were assessed using univariate analyses and multivariable logistic regression.
Results:
The prevalence of irregular antibodies was 8.04% (95% confidence interval [CI]: 7.0-9.1). Among positive cases, 66.82% had a single antibody, most commonly anti-E (35.51%) and anti-Mia (14.02%). The most frequent antibody combination was anti-c and anti-E (13.08%). Factors significantly associated with antibody formation after adjustment included a higher number of transfused red cell units (57.65 vs. 44.53 units, p = 0.000), absence of phenotype-matched transfusions (p = 0.017), non-Kinh ethnicity (p = 0.0003) and a diagnosis of thalassaemia (p = 0.0013).
Conclusion:
A relatively high prevalence of irregular red cell alloantibodies was observed in paediatric patients, predominantly involving antibodies of the Rh blood group system and anti-Miᵃ. These findings support the relevance of targeted antigen matching in settings where fully phenotype-matched red blood cells are not consistently available.
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