Ideally, application of extended matched phenotyping can prevent alloimmunization; however, it’s financially and logistically demanding in limited resources health services, so adoption of a transfusion policy that provide phenotypically matched blood for the most frequent significant alloantigens (Rh and Kell) may offer a balanced cost-effective alternative to minimize red cell alloimmunization and autoimmunization among patients with thalassemia. Here, KEL is linked to thalassemia.