Aloimunização eritrocitária em pacientes politransfundidos com doenças onco-hematológicas: uma revisão de literatura

Abstract

Alloimmunization is caused by exposure to erythrocytes from a donor who expresses antigens from blood groups different from those of the receptor, triggering an immune response of varying degrees. Multi-transfused patients, especially those with oncohematological diseases, are more predisposed to the risk of receiving incompatible blood components and developing alloantibodies. Thus, the objective of this literature review was to assess, which are the most frequent hematological malignance in alloimmunized multitransfused patients, to determine which are the most common erythrocyte antigens and antierythrocyte alloantibodies detected in the population profile of the study, as well as to identify appropriate measures to be taken to minimize alloimmunization rates in this transfusiondependent population. For this purpose, well-defined eligibility criteria were used, and the search took place in the electronic bibliographic database MEDLINE (through PubMed). Based on the criteria used, 10 articles were included to compose this review. It was observed that the most prevalent onco-hematological disease in the studied population was the Myelodysplastic Syndrome, as well as the frequent detection of alloantibodies associated with the Rh, Kell, MNS and Kidd systems. Furthermore, all studies pointed to extensive erythrocyte phenotyping as a way of minimizing alloimmunization rates among patients with hematological malignancies, as well as reducing the risks of occurrence of transfusion hemolytic reactions. Thus, although the reality represented in transfusion medicine is very different between countries, the performance of phenotyping and genotyping to identify systems other than ABO/Rh, especially for chronically transfused patients who have Myelodysplastic Syndrome, can minimize the risk of alloimmunization and its consequences, with positive effects on the safety and efficacy of transfusion therapy.