In this blog, Prof Cheng-Hock Toh and Dr Nnenna Osuji consider the benefits of blood group genotyping for people with sickle cell disorder, thalassaemia and other inherited red blood cell disorders.
Blood transfusion has an important role in the management of patients with sickle cell disorder and thalassaemia and other red blood cell disorders. It is lifesaving and often required on a long- term basis.
Due to differences in blood groups between blood donors and patients with sickle cell disorder and thalassaemia, immune reactions sometimes occur, caused by a formation of antibodies that attack red blood cell proteins. A national audit showed 17% of people with sickle cell disorder and 22% of those with thalassaemia form antibodies following blood transfusion.
Blood group genotyping for people with sickle cell disorder and other transfusion dependent inherited anaemias symbolises a new way forward that will transform lives. Analysing each patient’s blood group down to a much greater level of detail will aid better matching of blood in the future, reducing transfusion side effects.
Increasing the level of matching for patients most at risk will reduce complications and contribute to a better quality of life for patients whose lives are already disproportionately spent within health services.
I am delighted that we now have the technology to genotype red blood cells for patients with red cell disorders and donors so that in the future we can find best compatible blood from the offset and throughout the patient’s transfusion journey.
These patients have multiple transfusions through their lifetime, and it becomes harder and harder to cross match leading to difficulty and delay in finding compatible blood. This technology will allow us to get it right first time and provide more personalised transfusion treatment for patients over their lifetime, significantly improving their quality of care.
I am pleased to see that this area of practice has received significant funding, which demonstrates the importance of developing more tailored approaches to care for those living with genetic disorders.
Prof Cheng-Hock Toh, Chair of the National Blood Transfusion Committee
Red blood cell disorders are inherited – sickle cell disorder mostly affects people of Black African and Caribbean heritage with about 17,000 patients in England living with this disorder. Thalassaemia is mainly seen in those with an Asian and Southern Mediterranean heritage, with about 800 patients in England.
Patients impacted by these conditions can be shackled to health services, with intense pain or extreme tiredness significantly impacting their ability to enjoy day-to-day life.
The ‘No One’s Listening’ (Nov 2021) report by the All-Party Parliamentary Group on Sickle Cell and Thalassaemia highlighted that we must do better for these patients, and that to fail to do so, was an issue of inequity.
I am greatly encouraged by the development of the technology that will enable blood group genotyping for those with red cell disorders, which will, in the future, deliver a step change in the care for patients and will reduce the morbidity and health challenges faced by this community.
Dr Nnenna Osuji, Chief Executive Officer of North Middlesex University Hospital NHS Trust and Consultant Haematologist
This development symbolises and reinforces the NHS commitment to reducing healthcare inequalities.
It’s a new way of providing care for our patients and it better equips all of us: patients, lab scientists, haematologists, and donors, all of whom are critical to its success.
We will be able to offer treatment that is tailored to the individual’s needs and transforms our ability to get the right blood to the right patient at the right time.
It is a significant step to reducing health inequity and challenges the one-size-fits-all approach to healthcare.
Treatment will still depend on the availability of suitable donors and there remains an urgent need for more people of Black and Asian heritage to register as blood donors at www.blood.co.uk.
Sampling is expected to begin later this year and you can find out more information at: www.nhsbt.nhs.uk/what-we-do/clinical-and-research/blood-group-genotyping/.