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Pirenne, F.
Transfusion clinique et biologique, 20/May , Volume: 26, Issue: 2Journal Article
Post-transfusion hemolysis is the most frequent immune reaction to transfusion in sickle cell disease. Its frequency is underestimated due to its biological and clinical characteristics. It results principally from the high incidence of alloimmunization in these patients, but no antibodies are detectable in 30% of cases. Prevention is based on the prevention of alloimmunization through the use of matched RBCs for highly immunogenic blood groups, taking into account the patient's transfusion history, particularly in patients undergoing occasional transfusion, which is associated with a higher risk of DHTR development than chronic transfusion. In addition to the use of matched RBCs, the prevention of alloimmunization through immunotherapy should be considered. L’hémolyse post-transfusionnelle du patient drépanocytaire est une réaction fréquente chez les patients transfusés ponctuellement, mais sous-estimée du fait de ses caractéristiques immuno-hématologiques et cliniques. L’alloimmunisation anti-érythrocytaire reste la principale cause de cet accident, ceci étant, il existe un certain nombre de cas sans anticorps détectables. La prévention repose donc sur la prévention de l’alloimmunisation, mais tient aussi compte de l’historique transfusionnel des patients, et particulièrement chez les patients transfusés ponctuellement, présentant un risque plus élevé de DHTR. La prévention repose sur l’accès à des CGR phénotypés, mais aussi sur une prévention non spécifique par des traitements immuno-modulateurs, comme le rituximab.
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