High Percentage of Evanescent Red Cell Antibodies in Patients with Sickle Cell Disease Highlights Need for a National Antibody Database

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Abstract

Objectives

Alloantibody formation secondary to transfusion in patients with sickle cell disease (SCD) is a well-known phenomenon. Pretransfusion testing (eg, “antibody screening”) protects patients from receiving incompatible red blood cell transfusions. Because alloantibodies have a tendency to evanesce (ie, become undetectable over time), however, this phenomenon puts patients at risk of a delayed hemolytic transfusion reaction or even acute hemolysis.

Methods

We evaluated the records of 71 patients with SCD with alloantibodies detected during a 2-year period to describe their most common specificities and their rate of evanescence.

Results

We found that 81% of patients had at least one antibody that was undetectable during the study period; therefore, if patients were transfused with antigen-positive units at a facility that was unaware of their antibody history, life-threatening hemolysis could develop.

Conclusions

Evanescence is a real risk for patients with SCD, and national/regional databases of alloantibodies should be considered a priority.

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