Prevalence of Unexpected Antibodies in Thalassemia Patients in Isfahan, Iran

Abstract

Background: Patients with β thalassemia major, due to their lifelong reliance on blood transfusions, are at an elevated risk of alloimmunization against red blood cell antigens. The present study was conducted to determine the prevalence and pattern of red blood cell alloantibodies in transfusion dependent thalassemia patients in Isfahan, Iran. Methods: This descriptive-analytical cross-sectional study was performed on 483 patients with β thalassemia major who were referred to the Hematology Department of Seyed al Shohada Hospital in Isfahan. Alloantibody screening and, in positive cases, antibody identification were performed using the tube method. The Mann-Whitney U test was used to compare mean age between sexes, and the Chi-square test was applied to compare antibody proportions between groups. A P value of less than 0.05 was considered statistically significant. Findings: Of the 483 patients evaluated, 279 (57.8) were female and 204 (42.2) were male. The overall prevalence of alloimmunization was estimated at 15.11. The most frequently identified alloantibody was anti-Kell, with a frequency of 8.5, followed by anti-D at 4.6 and anti-E at 2.1. The prevalence of anti-D was significantly higher in females than in males (6.5 vs. 2.0; P = 0.019). Conclusion: Overall, the present study demonstrates a notable prevalence of RBC alloimmunization among thalassemia patients in Isfahan, with the Kell blood group system accounting for the majority of identified alloantibodies. In particular, the higher rate of anti-D immunization observed in female patients emphasizes the necessity of comprehensive antenatal care and RhD prophylaxis to mitigate potential transfusion-related complications. © 2026, Isfahan University of Medical Sciences(IUMS). All rights reserved.