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Frequency of Allo-Immunization in Sickle Cell Disease: Case of the Patients at the Laquintinie Hospital in Douala-Cameroon

Received: 7 April 2022    Accepted: 21 April 2022    Published: 10 May 2022
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Abstract

Background: Allo-immunization is an immune response to foreign antigens after exposure to genetically different cells or tissues. Allo-immunized patients with sickle cell disease (SCD) appear to experience worse survival compared to non allo-immunized patients. Therefore, to contribute to the management of patients living with SCD and improve the blood transfusion process, we aimed to determine the frequency of allo-immunization in SCD’s patients. To realize this study, we carry out a cross sectional study in one Hospital of Douala-Cameroon. Method: Plasma was prepared from collected blood sample, electrophoresis was done and depending on the migration on the gel; the type of electrophoresis was determine. Blood group ABO/Rh was done. After electrophoresis, depending on the result obtained those that was not homozygote (SS) and heterozygote sickle cell anemia (AS) was discarded. The check for irregular agglutinins was done using the indirect Coombs test. Clinical and biological characteristics of the different participants were studied and analyzed using a Statview statistical software. Result: We obtained 104 sickle cell patient, out of these we had 55% of positive RAI, with an average transfusion of 7.35. Also 83 patients were homozygote sickle cell anemia for a mean age of 15.75 years old (ranging from 1 to 52 years). The result obtained shows that the number of blood transfusion for homozygote sickle cell patient increases with age and that homozygote sickle cell patient received more blood transfusion than heterozygote patient. It can also be said that allo-immunization in these patients originate from the multiple blood transfusion received that were not fully compatible and that it affects more children (from 1 – 15), they accounted for about 53.85% of the total population. Our result obtained implies that in the future, sickle cell patient will have difficulty in finding compatible blood for treatment and is a real problem since transfusion is the major standard of care for patient suffering from sickle cell anemia in Cameroon. The absence of treatment may lead to the death of the patient. To help reduced allo-immunization, extended compatibility test in all the red blood cell system and routinely screening for the presence of irregulars agglutinins may reduce the frequency of allo-immunization.

Published in European Journal of Clinical and Biomedical Sciences (Volume 8, Issue 3)
DOI 10.11648/j.ejcbs.20220803.12
Page(s) 38-43
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Allo-immunization, Homozygote Sickle Cell Patient, RAI, Blood Transfusion

References
[1] Okpala I. Epidemiology, genetics and pathophysiology of sickle cell disease. In: Practical management of haemoglobinopathies. 1st ed. Oxford: Blackwell Publishing Ltd; 2004.
[2] Zimring JC, Welniak L, Semple JW, Ness PM, Slichter SJ, Spitalnik SL, NHLBI Allo-immunization Working Group Current problems and future directions of transfusion-induced allo-immunization: summary of an NHLBI working group. Transfusion. 2011; 51 (2): 435–441.
[3] Daniels G, Poole J, de Silva M, Callaghan T, MacLennan S, Smith N. The clinical significance of blood group antibodies. Transfus Med. 2002; 12: 287–95.
[4] Bajpai M, Gupta S, Jain P. Allo-immunization in multitransfused liver disease patients: Impact of underlying disease. Asian J Transfus Sci. 2016; 10 (2): 136-39.
[5] Sekongo YM, Dasse SR, Altemeyer A, Soraya A, Tayou C, Anani Lc, Kassogue K, Geisen C, Herbrich A, Kouamenan S, Konate S. Prevalence of Anti Erythocyte Allo-immunization to Sub-Saharan African Blood Donors. International Journal of Immunology. 2019; 7 (2): 33-36.
[6] Mota MA Red cell and human leukocyte antigen allo-immunization in candidates for renal transplantation: a reality. Rev Bras Hematol Hemoter. 2013; 35 (3): 160–161.
[7] M. Baby, S. Fongoro et al, Frequency of red blood cell allo-immunization in polytransfused patients at the university teaching hospital of Point G, Bamako, Mali. 2010 Oct; 17 (4): 218-22.
[8] Chibuzo O’suiji, Robert I. Liem, Q. Kyle Mack, Paris Kingberry, Glenn Ramsey, Alexis A. Thompson and al. allo-immunization in sickle cell anemia in the era of extended red cell typing. 2013 Mar 18.
[9] Rosanna Mortelecque, Anne Mercadier and al, Anti-erythrocyte antibody testing, France 2011.
[10] P. Moncharmont, F. Meyer, Apparition d’anticorps irréguliers anti-érythrocytaire chez les patients transfuses âgés de 80 ans et plus: résultats sur deux périodes de 3 ans, France. 2014; 21 (34): 261.
[11] O. Atouf, C. Brick, N. Benseffaj, S. Ouadghiri, H. El Annaz, et M. Essakalli, Recherche des anticorps anti-érythrocytaire en milieu hospitalier: à propos de 2027 patients marocains. 2013; 28 (4): 240-244.
[12] Lilian A Boateng, Andrew D Campbell, Robertson D. Davenport, Alex Osei-Akotto, Sheri Hugan, Akwasi Asamoah and al. Red blood cell allo-immunization and minor red blood cell antigen phenotypes in transfused Ghanaian patients with sickle cell Ghana. 2019; 59 (6): 2016-2022.
[13] F. Ben Laklal, N. Ben Salah, Z. El Borgi, R. Hafsia et hpoital Aziza Othmana. Etude des spécificités anti-érythrocytaire en, milieu hématologique. 2015; 22.
[14] Traore Oumou. Phénotype érythrocytaires dans les systèmes de groupes sanguins immunogènes chez les donneurs de sang de Bamako, 2002.
[15] WHO. Africa general committee, and al, sickle cell disease: a strategy for the WHO African region, Malabo Equatorial Guiney 30 August- 3 September 2010 sixtieth session. [https://apps.who.int/iris/handle/10665/1682].
[16] Tatjana Makarovska Bojadzieva, Emilija Velkova, Milenka Blagoevska. The impact of extended typing on red blood cell allo-immunization in transfused patients, Open Access Maced J Med Sci. 2017; 5 (2): 107–111.
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    Celianthe Guegang Guegang, Romaric De Manfouo Tuono, Simon Ngamli Fewou, Lazare Kaptue. (2022). Frequency of Allo-Immunization in Sickle Cell Disease: Case of the Patients at the Laquintinie Hospital in Douala-Cameroon. European Journal of Clinical and Biomedical Sciences, 8(3), 38-43. https://doi.org/10.11648/j.ejcbs.20220803.12

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    ACS Style

    Celianthe Guegang Guegang; Romaric De Manfouo Tuono; Simon Ngamli Fewou; Lazare Kaptue. Frequency of Allo-Immunization in Sickle Cell Disease: Case of the Patients at the Laquintinie Hospital in Douala-Cameroon. Eur. J. Clin. Biomed. Sci. 2022, 8(3), 38-43. doi: 10.11648/j.ejcbs.20220803.12

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    AMA Style

    Celianthe Guegang Guegang, Romaric De Manfouo Tuono, Simon Ngamli Fewou, Lazare Kaptue. Frequency of Allo-Immunization in Sickle Cell Disease: Case of the Patients at the Laquintinie Hospital in Douala-Cameroon. Eur J Clin Biomed Sci. 2022;8(3):38-43. doi: 10.11648/j.ejcbs.20220803.12

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  • @article{10.11648/j.ejcbs.20220803.12,
      author = {Celianthe Guegang Guegang and Romaric De Manfouo Tuono and Simon Ngamli Fewou and Lazare Kaptue},
      title = {Frequency of Allo-Immunization in Sickle Cell Disease: Case of the Patients at the Laquintinie Hospital in Douala-Cameroon},
      journal = {European Journal of Clinical and Biomedical Sciences},
      volume = {8},
      number = {3},
      pages = {38-43},
      doi = {10.11648/j.ejcbs.20220803.12},
      url = {https://doi.org/10.11648/j.ejcbs.20220803.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ejcbs.20220803.12},
      abstract = {Background: Allo-immunization is an immune response to foreign antigens after exposure to genetically different cells or tissues. Allo-immunized patients with sickle cell disease (SCD) appear to experience worse survival compared to non allo-immunized patients. Therefore, to contribute to the management of patients living with SCD and improve the blood transfusion process, we aimed to determine the frequency of allo-immunization in SCD’s patients. To realize this study, we carry out a cross sectional study in one Hospital of Douala-Cameroon. Method: Plasma was prepared from collected blood sample, electrophoresis was done and depending on the migration on the gel; the type of electrophoresis was determine. Blood group ABO/Rh was done. After electrophoresis, depending on the result obtained those that was not homozygote (SS) and heterozygote sickle cell anemia (AS) was discarded. The check for irregular agglutinins was done using the indirect Coombs test. Clinical and biological characteristics of the different participants were studied and analyzed using a Statview statistical software. Result: We obtained 104 sickle cell patient, out of these we had 55% of positive RAI, with an average transfusion of 7.35. Also 83 patients were homozygote sickle cell anemia for a mean age of 15.75 years old (ranging from 1 to 52 years). The result obtained shows that the number of blood transfusion for homozygote sickle cell patient increases with age and that homozygote sickle cell patient received more blood transfusion than heterozygote patient. It can also be said that allo-immunization in these patients originate from the multiple blood transfusion received that were not fully compatible and that it affects more children (from 1 – 15), they accounted for about 53.85% of the total population. Our result obtained implies that in the future, sickle cell patient will have difficulty in finding compatible blood for treatment and is a real problem since transfusion is the major standard of care for patient suffering from sickle cell anemia in Cameroon. The absence of treatment may lead to the death of the patient. To help reduced allo-immunization, extended compatibility test in all the red blood cell system and routinely screening for the presence of irregulars agglutinins may reduce the frequency of allo-immunization.},
     year = {2022}
    }
    

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  • TY  - JOUR
    T1  - Frequency of Allo-Immunization in Sickle Cell Disease: Case of the Patients at the Laquintinie Hospital in Douala-Cameroon
    AU  - Celianthe Guegang Guegang
    AU  - Romaric De Manfouo Tuono
    AU  - Simon Ngamli Fewou
    AU  - Lazare Kaptue
    Y1  - 2022/05/10
    PY  - 2022
    N1  - https://doi.org/10.11648/j.ejcbs.20220803.12
    DO  - 10.11648/j.ejcbs.20220803.12
    T2  - European Journal of Clinical and Biomedical Sciences
    JF  - European Journal of Clinical and Biomedical Sciences
    JO  - European Journal of Clinical and Biomedical Sciences
    SP  - 38
    EP  - 43
    PB  - Science Publishing Group
    SN  - 2575-5005
    UR  - https://doi.org/10.11648/j.ejcbs.20220803.12
    AB  - Background: Allo-immunization is an immune response to foreign antigens after exposure to genetically different cells or tissues. Allo-immunized patients with sickle cell disease (SCD) appear to experience worse survival compared to non allo-immunized patients. Therefore, to contribute to the management of patients living with SCD and improve the blood transfusion process, we aimed to determine the frequency of allo-immunization in SCD’s patients. To realize this study, we carry out a cross sectional study in one Hospital of Douala-Cameroon. Method: Plasma was prepared from collected blood sample, electrophoresis was done and depending on the migration on the gel; the type of electrophoresis was determine. Blood group ABO/Rh was done. After electrophoresis, depending on the result obtained those that was not homozygote (SS) and heterozygote sickle cell anemia (AS) was discarded. The check for irregular agglutinins was done using the indirect Coombs test. Clinical and biological characteristics of the different participants were studied and analyzed using a Statview statistical software. Result: We obtained 104 sickle cell patient, out of these we had 55% of positive RAI, with an average transfusion of 7.35. Also 83 patients were homozygote sickle cell anemia for a mean age of 15.75 years old (ranging from 1 to 52 years). The result obtained shows that the number of blood transfusion for homozygote sickle cell patient increases with age and that homozygote sickle cell patient received more blood transfusion than heterozygote patient. It can also be said that allo-immunization in these patients originate from the multiple blood transfusion received that were not fully compatible and that it affects more children (from 1 – 15), they accounted for about 53.85% of the total population. Our result obtained implies that in the future, sickle cell patient will have difficulty in finding compatible blood for treatment and is a real problem since transfusion is the major standard of care for patient suffering from sickle cell anemia in Cameroon. The absence of treatment may lead to the death of the patient. To help reduced allo-immunization, extended compatibility test in all the red blood cell system and routinely screening for the presence of irregulars agglutinins may reduce the frequency of allo-immunization.
    VL  - 8
    IS  - 3
    ER  - 

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Author Information
  • Institut of Sciences and Health, Université des Montagnes, Bangangté, Cameroun

  • Institut of Sciences and Health, Université des Montagnes, Bangangté, Cameroun

  • Institut of Sciences and Health, Université des Montagnes, Bangangté, Cameroun

  • Institut of Sciences and Health, Université des Montagnes, Bangangté, Cameroun

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