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The mean fluorescence intensities of anti‐ HLA antibodies detected using micro‐bead flow cytometry predict the risk of platelet transfusion refractoriness
Author(s) -
Beligaswatte Ashanka,
Tsiopelas Eleni,
Humphreys Ian,
Bennett Greg,
Robinson Kathryn,
Davis Ken,
Bardy Peter
Publication year - 2013
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.12369
Subject(s) - flow cytometry , platelet , medicine , human leukocyte antigen , platelet transfusion , confidence interval , antibody , immunology , receiver operating characteristic , logistic regression , neonatal alloimmune thrombocytopenia , antigen , gastroenterology , biology , pregnancy , fetus , genetics
Summary There are no accepted methods to predict the development of platelet transfusion refractoriness ( PTR ) due to human leucocyte antigen ( HLA )‐alloimmunization. Hence, matched platelets are usually given only to patients demonstrating PTR , necessarily resulting in some ineffective random donor platelets ( RDPLT ) transfusions. To assess its utility in predicting PTR , we retrospectively tested samples from 387 patients receiving chemotherapy for acute leukaemia or autologous transplantation using a micro‐bead flow cytometry assay. The average of the mean fluorescence intensities (avg MFI ) of the class I beads in the screening assay was correlated with outcomes of RDPLT transfusions during a 2 week period. Antibodies were detected in 57 patients; 66 developed PTR , of whom 28 were alloimmunized. avg MFI usefully predicted the development of PTR (area under the receiver operating curve 0·87, 95% confidence interval: 0·77–0·96). A logistic regression model estimated the probability of PTR to be >90% when avg MFI >5440. These results indicate that micro‐bead flow cytometry assays could inform a risk‐adapted strategy for managing thrombocytopaenic HLA allo‐immunized patients.