Transfusion under proinflammatory conditions increases the risk of alloimmunization (based on RBC units)
| Clinical variables . | Alloantibody-positive transfusions, n = 57 units . | Alloantibody-negative transfusions, n = 1021 units . | OR (95% CI)∗ . | P value . |
|---|---|---|---|---|
| Proinflammatory events | ||||
| Yes | 30 (52.6%) | 96 (9.4%) | 4.22 (1.64, 10.85) | .003 |
| No | 27 (47.4%) | 925 (90.6%) | — | — |
| Aplastic crisis | ||||
| Yes | 4 (7.0%) | 1 (0.1%) | 187.76 (4.67, 7542) | .006 |
| No | 53 (93.0%) | 1020 (99.9%) | — | — |
| Laboratory tests | ||||
| Hb (g/dL) | 9.90 (8.10∼10.40) | 10.60 (9.50∼11.30) | 0.79 (0.54, 1.14) | .203 |
| Absolute reticulocyte count (106/μL)† | 0.26 (0.15∼0.34) | 0.19 (0.15∼0.25) | 185.88 (0.05, 698390) | .212 |
| WBC (103/μL)‡ | 11.10 (6.30∼15.15) | 8.30 (6.30∼11.90) | 0.99 (0.91, 1.08) | .859 |
| ANC ((/μL)§ | 6350 (3350∼8100) | 3600 (2300∼6800) | 0.95 (0.84, 1.09) | .487 |
| LDH (unit/L) | 472 (384∼517) | 415 (356∼520) | 0.99 (0.67, 1.45) | .943 |
| Total bilirubin (mg/dL) | 4.20 (2.50∼6.40) | 2.30 (1.50∼3.80) | 1.15 (0.85, 1.55) | .368 |
| Clinical variables . | Alloantibody-positive transfusions, n = 57 units . | Alloantibody-negative transfusions, n = 1021 units . | OR (95% CI)∗ . | P value . |
|---|---|---|---|---|
| Proinflammatory events | ||||
| Yes | 30 (52.6%) | 96 (9.4%) | 4.22 (1.64, 10.85) | .003 |
| No | 27 (47.4%) | 925 (90.6%) | — | — |
| Aplastic crisis | ||||
| Yes | 4 (7.0%) | 1 (0.1%) | 187.76 (4.67, 7542) | .006 |
| No | 53 (93.0%) | 1020 (99.9%) | — | — |
| Laboratory tests | ||||
| Hb (g/dL) | 9.90 (8.10∼10.40) | 10.60 (9.50∼11.30) | 0.79 (0.54, 1.14) | .203 |
| Absolute reticulocyte count (106/μL)† | 0.26 (0.15∼0.34) | 0.19 (0.15∼0.25) | 185.88 (0.05, 698390) | .212 |
| WBC (103/μL)‡ | 11.10 (6.30∼15.15) | 8.30 (6.30∼11.90) | 0.99 (0.91, 1.08) | .859 |
| ANC ((/μL)§ | 6350 (3350∼8100) | 3600 (2300∼6800) | 0.95 (0.84, 1.09) | .487 |
| LDH (unit/L) | 472 (384∼517) | 415 (356∼520) | 0.99 (0.67, 1.45) | .943 |
| Total bilirubin (mg/dL) | 4.20 (2.50∼6.40) | 2.30 (1.50∼3.80) | 1.15 (0.85, 1.55) | .368 |
Categorical variables summarized as n (%). Continuous variables summarized as median (IQR, from Quartile 1 to Quartile 3). Indicated in bold, P < 0.05 is considered significant. ANC, absolute neutrophil count; LDH, lactate dehydrogenase; WBC, white blood cell.
The analyses included transfusions (units) up to 7 days before all newly identified alloantibodies. Since antibody-positive transfusions usually occurred at a later time than antibody-negative transfusions for an individual patient (OR by RBC units: 1.31, 95% CI: 1.11–1.56, P = 0.002), the association analyses were adjusted for patient age at the time of transfusions.
Exclude absolute reticulocyte counts during aplastic crisis.
The maximum WBC counts during 7 days before and after the indicated transfused unit/transfusion event.
OR for ANC was based on a 1000-unit increase. The ORs for the remaining laboratory results were based on a 1-unit increase.