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Vol.6 No.1 – 4: RBC Alloimmunization in Sudanese Multi-transfused Patients

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By: Hager Elkobani1, Sahar Elbager1*, Magdi A. Bayoumi2

1Faculty of Medical Laboratory Sciences, University of Medical Sciences and Technology (UMST), Sudan

2Faculty of Medical Laboratory Sciences, Ibn Sina University, Sudan

Abstract

Background: Blood transfusions are a life-saving measure to replace blood lost through severe bleeding or as a life-saving treatment for various hematological conditions. Blood transfusions are high-risk procedures. One of these risks is alloimmunization. Alloimmunization is an immune response to foreign antigens after exposure to genetically different cells or tissues. Alloimmunization is a frequent undesirable outcome of a blood transfusion. In this study, we investigated the frequency of alloimmunization and the factors associated with the development of antibodies in frequently transfused patients. Materials and Methods: A descriptive cross-sectional study carried out in Khartoum, Sudan between November 2017 and March 2018. The study population included 97 multi-transfused patients (Solid tumors, 41; Sickle cell anemia, 31; Leukemia; 25), 52 males and 45 females whose ages ranged between 3-81 years and each subject received a minimum of 2 units of RBCs. The number of blood units transfused varied among patients from 2 to over 20 units depending on the underline disease treatment needs. Antibody screen was performed using four-cell commercially prepared Grifols reagent RBCs and gel impregnated with antihuman globulin. Results: The overall alloimmunization frequency was 22.7%. The alloimmunization frequency in Sickle cell anemia patients was 29.0%, solid tumors patients; 21.9% and 16.0% in leukemic patients. Alloimmunization frequency was independent on a number of units transfused or gender (p value= 0.071, 0.942), respectively. Conclusion: Sudanese multi-transfused patients have higher rates of alloimmunization compared to other countries. It is our recommendation that pretransfusion protocols must include antibody screening. Timely antigen typing of donor’s blood and to transfuse only antigen-negative blood.

RBC Alloimmunization in Sudanese Multi-transfused Patients-converted

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Vol.4 No.2 – 2 : Clinical Manifestations of Philadelphia-negative Myeloproliferative Neoplasms in Sudan

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By :  Sahar  Elbager , Enaam Abdelgader , Samah Ali , Tahani Mursal , Nahid Yousif , Eltaher Osman , Amar Dowd , Magdi Bayoumi

 

Abstract

Background/ objective: The Philadelphia-negative chronic myeloproliferative neoplasms (MPNs), is a heterogeneous group of oncohematological diseases that express a high burden of symptoms that significantly affect patient quality of life and are associated with high morbidity and premature mortality. This study aimed to determine the clinical manifestations of MPNs in Sudanese population.

Method: A retrospective study was carried out in the Radiation and Isotope Center at Khartoum (RICK), Sudan. 290 medical records of MPNs were examined.

Results: Polycythemia Vera (PV) was the most frequent (64.1%) with a median age at diagnosis of 50 years. It was, followed by Essential Thrombocythemia (ET) (28.6%, median age 48years) and Primary Myelofibrosis (PMF) (7.3%, median age 58years). Male patients had mostly a history of PV (p < 0.05). Females were predominately affected by ET (p < 0.05), despite the gender distribution of PMF patients was approximately similar (p > 0.05). Among PV cases, the main symptoms present at diagnosis were fatigue with fever reported by 31.2% of cases followed by headache (26.6%), joint pain (24.2%), splenomegaly (14.2%), hepatosplenomegaly and thrombotic complications. In ET, 43.4% of the cases complained about headache followed by fatigue associated with fever, joint pain, splenomegaly, hepatosplenomegaly. None of ET cases presented bleeding or thrombotic complications. In PMF cases, the main symptoms were fatigue with fever (19%) followed by joint pain, headache, fever, bleeding, thrombotic complication, splenomegaly, hepatosplenomegaly.

Conclusion: The current study showed that in Sudan, MPNs affects a younger population and PV was more prevalent than ET and PMF. The findings also revealed that headache, fatigue and joint pain were the most frequent symptoms.

Clinical Manifestations of Philadelphia-negative Myeloproliferative Neoplasms in Sudan (2) (1)

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