Frequency of red blood cell allo-immunization in patients undergoing blood transfusion at the Uganda Cancer Institute

• Published in: African health sciences 2023-12, Vol.23 (4), p.362-370
• Main Authors: Okello, Clement D, Shih, Andrew W, Nabwana, Martin, Kiwanuka, Noah, Heddle, Nancy, Mayanja-Kizza, Harriet, Orem, Jackson
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Blood Transfusion; Erythrocytes - immunology; Female; Humans; Isoantibodies - blood; Isoantibodies - immunology; Male; Middle Aged; Neoplasms - immunology; Transfusion Reaction - epidemiology; Transfusion Reaction - immunology; Uganda - epidemiology; Young Adult
• ISSN: 1680-6905; 1729-0503; 1729-0503
• DOI: 10.4314/ahs.v23i4.39

There is limited data on red blood cell (RBC) alloimmunization in patients with cancer in sub-Saharan Africa (SSA). We examined the frequency of RBC alloimmunization in transfused patients with cancers in Uganda. A randomized control trial was conducted on participants at the Uganda Cancer Institute. Eligible participants were age ≥15 years and required blood transfusion. Participants were randomized to receive either leucoreduced or non-leucoreduced blood transfusion. Participants' plasma samples were screened for RBC alloantibodies at enrolment and 3-4 weeks after blood transfusion using a 2-cell panel of reagent group O RBCs using the tube method. Antibody identification was performed using a 10-cell panels of reagent RBCs. Participants were considered alloimmunized if antibodies to RBC antigens were identified. A total of 277 participants were randomized (leucoreduced blood, n=137; non-leucoreduced blood, n=140). Overall, the most represented diagnoses were gynaecological cancers (n=88, 31.8%), acute leukaemia (n=35, 12.6%), and gastrointestinal cancers (n=25, 9.0%). Concomitant HIV infection was present in 26 (9.4%) participants. Most participants received