Using Blood Group Genotyping to Predict Hemolysis in Patients With β-Thalassemia Major With Frequent Transfusions: Protocol for a Cross-Sectional Study
Bibliographic record
Abstract
BACKGROUND: Hemolytic transfusion reactions are a major complication in patients with β-thalassemia major receiving regular transfusions. These reactions can be influenced by blood group incompatibilities, particularly in settings with limited genotyping practices. In Indonesia, the role of blood group genotyping in predicting hemolysis has not been thoroughly studied. OBJECTIVE: This study aims to analyze the association between blood group genotyping and the incidence of hemolysis in people with thalassemia undergoing repeated transfusions. METHODS: This is a cross-sectional study involving people with β-thalassemia major younger than 18 years old who received regular transfusion with intervals of 2-4 weeks and have received more than 20 units of transfusion. Participants with leukemia, lymphoproliferative diseases, diabetes, solid tumors, and immunosuppression disorders were excluded from the study. Genotyping examination was conducted using Allele-Specific polymerase chain reaction (PCR ASP) while phenotyping was examined using immunoserology. Follow-up gene sequencing was conducted to observe the blood group variants. Hemolysis was assessed using several markers such as haptoglobin, free hemoglobin, lactate dehydrogenase, bilirubin, and hemoglobinuria, measured by Cobas C113, the enzyme-linked immunosorbent assay, and urinalysis. RESULTS: Clinical and laboratory data collection is completed. A total of 90 samples were collected, data analyses were undertaken, and the initial results were reported in September 2024. CONCLUSIONS: The results of this study will provide information on the blood groups' systems that can predict hemolysis occurrence in patients with β-thalassemia undergoing repeated transfusion. These data will contribute to the best possible patient care management and blood transfusion therapy, thereby reducing the risk of hemolysis and improving the quality of life for patients with thalassemia in Indonesia. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/64379.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.007 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.011 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".