Evidence map›Paper›PMID 41065546›Full record

ArticleTransfusion2025

Strategies to mitigate transfusion-associated red blood cell alloimmunization in sickle cell disease: A retrospective analysis.

Elizabeth P Crowe, Chinelo P Onyenekwu, Jordan Ippolito, Xinyi Feng, Heather Smetana, Ruchika Goel, Jeremy W Jacobs, Paul M Ness, David Daniel, Herleen Rai and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Transfusion, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Elizabeth P CroweDivision of Transfusion Medicine, Department of Pathology, Johns Hopkins University, Baltimore, Maryland, USA.ORCID https://orcid.org/0000-0003-1910-2800
Chinelo P OnyenekwuDivision of Transfusion Medicine, Department of Pathology, Johns Hopkins University, Baltimore, Maryland, USA.
Jordan IppolitoDivision of Transfusion Medicine, Department of Pathology, Johns Hopkins University, Baltimore, Maryland, USA.
Xinyi FengDivision of Transfusion Medicine, Department of Pathology, Johns Hopkins University, Baltimore, Maryland, USA.
Heather SmetanaDivision of Transfusion Medicine, Department of Pathology, Johns Hopkins University, Baltimore, Maryland, USA.
Ruchika GoelDivision of Transfusion Medicine, Department of Pathology, Johns Hopkins University, Baltimore, Maryland, USA.
Jeremy W JacobsDepartment of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.ORCID https://orcid.org/0000-0002-5719-9685
Paul M NessDivision of Transfusion Medicine, Department of Pathology, Johns Hopkins University, Baltimore, Maryland, USA.
David DanielDivision of Transfusion Medicine, Department of Pathology, Johns Hopkins University, Baltimore, Maryland, USA.ORCID https://orcid.org/0000-0001-9670-1917
Herleen RaiDivision of Transfusion Medicine, Department of Pathology, Johns Hopkins University, Baltimore, Maryland, USA.ORCID https://orcid.org/0000-0001-6072-6098
Aaron A R TobianDivision of Transfusion Medicine, Department of Pathology, Johns Hopkins University, Baltimore, Maryland, USA.ORCID https://orcid.org/0000-0002-0517-3766
Kathy HaddawayDivision of Transfusion Medicine, Department of Pathology, Johns Hopkins University, Baltimore, Maryland, USA.
Evan M BlochDivision of Transfusion Medicine, Department of Pathology, Johns Hopkins University, Baltimore, Maryland, USA.ORCID https://orcid.org/0000-0001-8181-9517

Funding

The Malaria Transfusion Risk (MATRix) StudyK23HL151826 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI BLOCH, EVAN MARTIN · 2020 to 2024
$882k
EMB's effort is supported in part by the National Heart Lung and Blood Institute 1K23HL151826NHLBI NIH HHS K23 HL151826
6 · The paper itself

Abstract

backgroundThe American Society of Hematology (ASH) recommends prophylactic limited red blood cell (RBC) antigen matching for C, E, and K for patients with sickle cell disease (SCD). At our institution, reflexive extended antigen matching is employed: no antigen matching is undertaken initially; in the event of RBC alloimmunization, extended antigen matching (C/c, E/e, K, Fy STUDY DESIGN AND

methodsWe compared alloimmunization rates and costs of reflexive extended antigen matching with other RBC antigen-matching strategies. A 5-year retrospective review was conducted of all patients with SCD, who were transfused during the study period and lacked prior immunization. Age, sex, ABO/Rh type, number of transfused units of RBCs, antibody history, and transfusion reactions were assessed. The alloimmunization rate was defined as the number of new alloantibodies per 100 units of transfused RBCs. Costs were estimated for reflexive extended antigen matching, limited antigen matching, and extended antigen matching.

resultsOf 805 patients, 325 (40.4%) met inclusion criteria. Fifty (50/325, 15.4%) patients developed a positive antibody-detection test after transfusing a median of 9 (interquartile range: 3-14) units (alloimmunization rate 0.29 per 100 RBCs); anti-C, E, and K were leading alloantibodies. Seven (7/50, 14.0%) responders developed additional antibodies. Two delayed hemolytic transfusion reactions (DHTRs) were reported. Reflexive extended antigen-matching cost $4,619,133 over the 5-year period; projected costs of prophylactic limited and extended antigen matching were $9,578,253 (+107%) and $14,537,373 (+215%), respectively. DISCUSSION: Acknowledging the limitation of excluding some responders, the rates of alloimmunization and DHTRs, and comparatively low costs suggest that reflexive extended antigen matching is viable for selected settings.

Indexed as

Anemia, Sickle CellBlood Group IncompatibilityBlood Grouping and CrossmatchingErythrocytesErythrocyte TransfusionIsoantibodiesTransfusion ReactionAdolescentAdultBlood Group AntigensChildFemaleHumansMaleMiddle AgedRetrospective StudiesBlood Group AntigensIsoantibodiesalloimmunizationanemiacost–benefit analysiserythrocyte transfusionsickle cell

Identifiers

PMID41065546
PMCPMC12614347

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.