Treatments for hematological malignancies in contrast to those for solid cancers are associated with reduced red cell alloimmunization.

This study aims to quantify the associations of hematological malignancies and solid cancers with red cell alloimmunization in patients receiving red cell transfusions. We performed a nested multicenter case-control study in a source population of 24,063 patients receiving their first and subsequent red cell transfusions during an eight year follow-up period. Cases (N=505), defined as patients developing a first transfusion-induced red cell alloantibody, were each compared with two non-alloimmunized controls (N=1,010) who received a similar number of red cell units. Using multivariate logistic regression analyses, we evaluated the association of various malignancies and treatment regimens with alloimmunization during a delineated 5-week risk period. The incidence of alloimmunization among patients with acute (myeloid or lymphoid) leukemia and mature (B or T-cell) lymphoma was significantly reduced as compared to patients without these malignancies (adjusted relative risks (RR) with 95% confidence interval (CI) 0.36 (0.19-0.68) and 0.30 (CI 0.12-0.81)). Associations were primarily explained by immunosuppressive treatments (RR for (any type of) chemotherapy combined with immunotherapy 0.27, CI 0.09-0.83). Alloimmunization risks were similarly diminished in allogeneic or autologous stem cell transplanted patients (RR 0.34, CI 0.16-0.74), at least during the six months post-transplantation. Alloimmunization risks of patients with other hematological diseases, solid cancers, and t...
Source: Haematologica - Category: Hematology Authors: Tags: Haematologica Source Type: research