Prevalence of red blood cell alloimmunization in single and multiple transfused cancer patients and its associated factors in northern Tanzania

Abstract

Abstract Cancer patients frequently require blood transfusions which may lead to red blood cell alloimmunization which causes delayed haemolytic reactions, difficulty in finding compatible blood and transfusion delays. In Tanzania, blood banks screen for ABO and RhD antigens, while data on alloimmunization remain limited. The present study evaluated the prevalence of red blood cell alloimmunization in single- and multiple-transfused cancer patients and its associated factors at Kilimanjaro Christian Medical Centre, zonal referral Hospital in northern Tanzania. This cross-sectional study was conducted in northern Tanzania, where a total of 186 transfused cancer patients were recruited through consecutive sampling. Blood samples were collected from participants for alloantibody screening and identification. Descriptive statistics was used determine the proportions of the transfused cancer patients. The Fisher’s exact test was used to determine the significant association between independence variables and alloimmunization. The Mann–Whitney U test was used to compare the number of units of blood transfused between alloimmunized and non-alloimmunized patients. Firth’s penalized likelihood logistic regression was applied to determine factors associated with alloimmunization. Among 186 blood transfused cancer patients the overall prevalence of red blood cell alloimmunization was 5.9%. Red blood cell alloimmunization prevalence was 2.1% and 9.7% among single and multiple-transfused cancer patients, respectively. Anti-E 5/15(33.3%) and anti-Kell 4/15(26.7%) were the most common alloantibodies, followed by anti-C and anti-Lea 2/15(13.3%) each and two undetected antibodies. Multiple number of blood units transfused significantly increased the odds of alloimmunization (AOR = 1.21; 95% CI: 1.05–1.39; p = 0.007), whereas age (AOR = 1.03; 95% CI: 0.99–1.08; p = 0.095), female gender (AOR = 1.71; 95% CI: 0.49–6.00; p = 0.401), haematological cancer type (AOR = 0.94; 95% CI: 0.26–3.38; p = 0.925), and non-O blood groups (AOR = 1.94; 95% CI: 0.54–6.90; p = 0.308), were not statistically significantly associated with RBC alloimmunization. No significant associations were found with ABO blood groups. RBC alloimmunization was observed among transfused patients, with a greater occurrence among individuals exposed to multiple transfusions. Ant E and K were the common RBC alloantibodies identified. Number of units transfused are significantly associated with alloimmunization. Hence there is need to implement alloantibody screening and identification in order to improve transfusion safety in Tanzania.

The authors' abstract, as published at the source. Scientific Reports, 2026 · DOI ↗