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Randomized Controlled Trial
. 2023 Dec;23(4):362-370.
doi: 10.4314/ahs.v23i4.39.

Frequency of red blood cell allo-immunization in patients undergoing blood transfusion at the Uganda Cancer Institute

Clement D Okello  1 , Andrew W Shih  2 , Martin Nabwana  3 , Noah Kiwanuka  4 , Nancy Heddle  5 , Harriet Mayanja-Kizza  6 , Jackson Orem  1
Affiliations
Randomized Controlled Trial

Frequency of red blood cell allo-immunization in patients undergoing blood transfusion at the Uganda Cancer Institute

Clement D Okello et al. Afr Health Sci. 2023 Dec.

Abstract

Background: There is limited data on red blood cell (RBC) alloimmunization in patients with cancer in sub-Saharan Africa (SSA). We examined the frequency of RBC alloimmunization in transfused patients with cancers in Uganda.

Methods: A randomized control trial was conducted on participants at the Uganda Cancer Institute. Eligible participants were age ≥15 years and required blood transfusion. Participants were randomized to receive either leucoreduced or non-leucoreduced blood transfusion. Participants' plasma samples were screened for RBC alloantibodies at enrolment and 3-4 weeks after blood transfusion using a 2-cell panel of reagent group O RBCs using the tube method. Antibody identification was performed using a 10-cell panels of reagent RBCs. Participants were considered alloimmunized if antibodies to RBC antigens were identified.

Results: A total of 277 participants were randomized (leucoreduced blood, n=137; non-leucoreduced blood, n=140). Overall, the most represented diagnoses were gynaecological cancers (n=88, 31.8%), acute leukaemia (n=35, 12.6%), and gastrointestinal cancers (n=25, 9.0%). Concomitant HIV infection was present in 26 (9.4%) participants. Most participants received <5 units of blood during the study. No study participant developed allo-antibodies.

Conclusion: There was no RBC alloimmunization in participants with cancers. Routine RBC allo-antibody screening in all patients with cancer in SSA requires further research.

Keywords: Allo-immunization; Cancer; Uganda; blood; transfusion.

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Conflict of interest statement

All authors declare no competing interests.

Figures

Figure 1
Figure 1
Screening, randomization & follow up
See this image and copyright information in PMC

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