Avaliação imunohematológica e influência da aloimunização eritrocitária na evolução clínica dos pacientes com anemia falciforme

Abstract

Introduction: Sickle cell anemia is a genetic disease responsible for the production of hemoglobin S, with a wide variety of clinical presentations. One of the most widespread therapies for its treatment is hemotransfusion, which although it offers clinical benefit, is not free of complications, like alloimmunization. The presence of auto and alloantibodies is a relevant factor in the selection and availability of blood products for treatment. The relationship between the presence of alloimmunization and the clinical and laboratory manifestations of this disease is little studied in the literature and the objective of the present study is to evaluate the frequency of antibodies and the relationship between alloimmunization and clinical and laboratory abnormalities in sickle cell anemia. Methods: This is a historical cohort study, in which the medical records of patients with sickle cell anemia at the pediatric hematology outpatient clinic of the University Hospital of the Federal University of Sergipe were reviewed. Patients were phenotyped as a pre-transfusion routine at the local hemocenter. The mean of the last five laboratory tests and the frequency of various clinical complications were compared between alloimmunized and non-alloimmunized patients. Results: The prevalence of alloimmunized patients in the study was 19.6% with 12 types of alloantibodies found. There was an association between older age and higher number of transfusions and use of hydroxyurea with alloimmunization, since neonatal screening was not protective. The presence of irregular antibodies was directly related to the presence of autoantibodies and to higher values of mean corpuscular volume (MCV). The other clinical variables were not significantly influenced by alloimmunization