Predictors of autoimmune hemolytic anemia in beta-thalassemia patients with underlying red blood cells autoantibodies

Publication date: Available online 29 June 2019Source: Blood Cells, Molecules, and DiseasesAuthor(s): Monia Ben Khaled, Monia Ouederni, Nessrine Sahli, Nawel Dhouib, Ahmed Ben Abdelaziz, Samia Rekaya, Ridha Kouki, Houda Kaabi, Hmida Slama, Fethi Mellouli, Mohamed BejaouiAbstractIn beta-thalassemia patients, erythrocyte autoantibodies can remain silent or lead to Autoimmune Hemolytic Anemia (AIHA).The aim of this study was to identify predictors of AIHA in beta-thalassemia patients with positive Direct Antiglobulin Test (DAT), in Tunisia.This longitudinal prognosis study was carried out on beta-thalassemia patients with a positive confirmed DAT. Predictors of AIHA were identified the Kaplan-Meier method. A Cox model analysis was used to identify independent predictors.Among 385 beta thalassemia patients, 87 developed positive DAT (22.6%). Autoimmune hemolytic anemia was occurred in 25 patients. Multivariate analysis showed that AIHA was independently associated with beta-thalassemia intermedia and similar family history of AIHA. Splenectomy in patients with positive DAT was independently associated with an increased risk of AIHA (HR = 6.175, CI: 2.049–18.612, p < 0.001). The risk of developing AIHA was higher during the first 72 transfusions. Autoimmune hemolytic anemia was significantly associated with polyspecific DAT (anti-complement and anti-IgG), blood group AB and prior alloimmunization. Whereas transfusion by phenotypic and leukoreduced blood was a protect...
Source: Blood Cells, Molecules, and Diseases - Category: Hematology Source Type: research