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Platelet antibodies in transfused patients
Author(s) -
Kiefel V.,
König C.,
Kroll H.,
Santoso S.
Publication year - 2000
Publication title -
transfusion medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.471
H-Index - 59
eISSN - 1365-3148
pISSN - 0958-7578
DOI - 10.1046/j.1365-3148.2000.00261-9.x
Subject(s) - antibody , platelet , medicine , isoantibodies , immunology , agglutination (biology) , human leukocyte antigen , panel reactive antibody , antigen
P atients and M ethods We studied sera of 252 patients with haematological or oncological diseases, who received multiple transfusions of rbc and/or platelet concentrates. The aim of our study was to analyse the specificity of platelet reactive antibodies (platelet specific and HLA‐antibodies) in a large series of transfused patients. All sera were analysed by platelet immunofluorescence, platelet agglutination, MAIPA and the lymphocytotoxic test (LCT). R esults Platelet reactive antibodies were detected in 113 patients. Among female patients with previous pregnancies 21/36 were alloimmunized but only 7/30 female patients who had not been pregnant ( P = 0·0049). In 108 (42·9%) of all sera, we found HLA‐specific antibodies. In a subset of 40 sera, reactions of HLA class I antibodies were compared with an identical cell panel using LCT and MAIPA assay. Twenty‐nine of these sera showed discrepant results in both techniques. Sera from 20 patients contained platelet specific alloantibodies with defined specificity: HPA‐5b (10), HPA‐1b (4), HPA‐5a (2) HPA‐1a (1), HPA‐2b (1), HPA‐5b + HPA‐1b (1), HPA‐1b + HPA‐2b (1). All sera with anti‐HPA‐1b contained additional HLA antibodies, 4 sera with anti‐HPA‐5b apparently contained no HLA‐antibodies. Ten sera contained ‘panreactive’ antibodies with broad specificity: GP IIb/IIIa (4), GP IIb/IIIa + Ia/IIa (2), GPIIb/IIIa + Ib/IX (1), GP IIb/IIIa + Ia/IIa + Ib/IX (3). C onclusion (1) Platelet alloantibody specificities in transfused patients (predominantly anti‐HPA‐5b and − 1b) differ significantly from those observed in neonatal alloimmune thrombocytopenia and post‐transfusion purpura, where anti‐HPA‐1a is the most prevalent specificity. (2) Results for detection of HLA‐antibodies differ considerably in relation to serological technique and target cells.