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ASH 2022 | Impact of implementing an RBC alloantibody exchange for SCD alloimmunisation

Red blood cell (RBC) alloimmunization rates and consequently delayed hemolytic transfusion reaction (DHTR) mortality in patients with sickle cell disease (SCD) is particularly high. Therefore, there is interest in implementing a blood bank information system alloantibody exchange in the United States (US), however cost is a concern. George Goshua, MD, MSc, Yale University School of Medicine, New Haven, CT, outlines the results of a study investigating the impact of an alloantibody exchange that enables alloantibody data-sharing across hospitals. The study involved the simulation of alloimmunized patients with SCD to project lifetime cumulative DHTR-specific mortality without an alloantibody exchange versus with a US-wide alloantibody exchange. It was found that implementing an alloantibody exchange versus not yields a decrease in cumulative lifetime DHTR-specific mortality (2.4% versus 5.7%, respectively). The absolute peak probability decrease of having a history of incident DHTR and being alive at age 41 was 27.0% versus 10.6%, respectively. Data also showed that per-person quality-adjusted life years (QALY) increases by 0.357 with exchange implementation. Financial data indicated that total lifetime costs accrue $1.0 billion with exchange as compared to $2.5 billion without, and an accrued incremental net monetary benefits (NMB) of $3 billion. Overall, an alloantibody exchange is predicted to be a life- and cost-saving investment for alloimmunized people living with SCD and importantly reduces DHTR-specific mortality. This press briefing took place at the 64th ASH Annual Meeting and Exposition congress in New Orleans, LA.

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