Narbey et al reported a score for predicting a delayed hemolytic transfusion reaction (DHTR) in a patient with sickle cell disease. This can help to guide patient management. The authors are from multiple institutions in France.
Patient selection: sickle cell disease
Outcome: delayed hemolytic transfusion reaction (DHTR)
Parameters:
(1) history of DHTR
(2) pretransfusion immunization
(3) number of units transfused previously
Parameter
Finding
Points
history of DHTR
no
0
yes
5
pretransfusion immunization
no alloantibodies
antibodies to Rh antigens or K or nonsignificant antigens
antibodies to antigens of significance
6
number of units transfused previously
< 12
8
>= 12
where:
• Significant alloantibodies include Fy, Jk and MNS.
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 19
• The higher the score the greater the risk of a delayed hemolytic transfusion reaction.
Score
Risk
Percent DHTR
0 to 7
low
1.6%
8 to 14
intermediate
15%
15 to 19
high
50%
Performance:
• The area under the ROC curve is 0.85.
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Specialty: Clinical Laboratory, Hematology Oncology
