Trusted Resources: Evidence & Education
Scientific literature and patient education texts
Alloimmunization in sickle cell disease: changing antibody specificities and association with chronic pain and decreased survival
source: Transfusion
year: 2015
authors: Telen MJ, Afenyi-Annan A, Garrett ME, Combs MR, Orringer EP, Ashley-Koch AE
summary/abstract:BACKGROUND:
Alloimmunization remains a significant complication of transfusion and has been associated with multiple factors, including inflammation, an important pathophysiologic mechanism in sickle cell disease (SCD). We explored whether alloimmunization is associated with disease severity in SCD.
STUDY DESIGN AND METHODS:
Adult SCD patients were enrolled in a study of outcome-modifying genes in SCD. Historical records of patients with SCD at two participating institutions were reviewed for data on antigen phenotype and alloimmunization. Differences in demographic, clinical, and laboratory findings; end-organ damage; and overall disease severity were then compared between alloimmunized and nonalloimmunized patients.
RESULTS:
Of 319 patients, 87 (27%) were alloimmunized. Alloantibody specificities differed from those previously described, especially due to the significantly higher frequency of anti-S. Although alloimmunization was not associated with frequency of vasoocclusive episodes, a higher percentage of alloimmunized patients had chronic pain, as defined by daily use of short-acting narcotics (p = 0.006), long-acting narcotics (p = 0.013), or both (p = 0.03). Additionally, alloimmunized patients had poorer survival (hazard ratio, 1.92; p = 0.01) and were more likely to have avascular necrosis (p = 0.024), end-organ damage (p = 0.049), and red blood cell autoantibodies (p < 0.001), even after controlling for the effects of age, sex, and hemoglobin diagnosis. Alloimmunization was not associated with other SCD-related complications, such as acute chest syndrome or stroke.
CONCLUSION:
Alloimmunization in SCD may be associated with chronic pain, risk of end-organ damage, and shorter survival. These novel findings suggest new directions for the investigation of immune response-mediated pathways common to alloimmunization and chronic pain.
DOI: 10.1111/trf.12940
read more full text
Related Content
-
Initial results from a cohort in a phase 2a study (GBT440-007) evaluating adolescents with sickle cell disease treat...Background: Sickle cell disease (SCD), ...
-
Predictors of acute care utilization and acute pain treatment outcomes in adults with sickle cell disease: The role ...Despite its rarity in the United States,...
-
First World Cord Blood Day on Nov. 15 to Highlight Cord Blood Uses, Stem Cell ResearchThe inaugural World Cord Blood Day on No...
-
Statement on NHLBI Decision to Pause the Pilot and Feasibility Study of Hematopoietic Stem Cell Gene Transfer for Si...bluebird bio, Inc. suspended its clinica...
-
LentiGlobin Shows Positive Effects in Severe Sickle Cell Disease Patients, Phase 1/2 Data ReportsBluebird bio presented new positive resu...
-
Greenville program tries team approach to improve lifespan of sickle cell disease patientsDr. Alan Anderson who was involved with ...
-
Crizanlizumab lowers pain crises in at-risk sickle cell patients, ad-hoc trial data showNovartis’ investigational th...
To improve your experience on this site, we use cookies. This includes cookies essential for the basic functioning of our website, cookies for analytics purposes, and cookies enabling us to personalize site content. By clicking on 'Accept' or any content on this site, you agree that cookies can be placed. You may adjust your browser's cookie settings to suit your preferences. More Information
The cookie settings on this website are set to "allow cookies" to give you the best browsing experience possible. If you continue to use this website without changing your cookie settings or you click "Accept" below then you are consenting to this.