Red cell antibodies in patients with homozygous sickle cell disease: a comparison of patients in Jamaica and the United Kingdom

The transfusion history and frequency of red cell antibodies in patients wi th homozygous sickle cell (SS) disease have been compared in 190 subjects f rom the Jamaican cohort study and 37 patients attending a sickle cell clini c in Manchester, England. The proportion of patients transfused did not dif fer between the groups although the number of units transfused and the freq uency of red cell antibodies were significantly greater in the Manchester g roup. Immune antibodies occurred in three Jamaicans (2.6% of those transfus ed) and 16 UK subjects (76% of those transfused). Multiple antibodies occur red in 10 (63%) UK subjects but in no Jamaicans. Indications for transfusio n also differed between the groups, Jamaican patients typically receiving 1 -2 units for acute anaemia or acute chest syndrome, whereas UK patients fre quently had multiple transfusions in preoperative exchange or prophylaxis p rogrammes. The greater red cell alloimmunization among UK patients probably reflects both the greater use of transfusion and the disparity between don or and recipient populations in the UK.