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Alloimmunization to RhD by Platelet Transfusions in Autologous Bone Marrow Transplant Recipients
Author(s) -
McLeod Bruce C.,
Piehl Michael R.,
Sassetti Richard J.
Publication year - 1990
Publication title -
vox sanguinis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.68
H-Index - 83
eISSN - 1423-0410
pISSN - 0042-9007
DOI - 10.1111/j.1423-0410.1990.tb00856.x
Subject(s) - medicine , platelet , platelet transfusion , adverse effect , surgery , chemotherapy , transplantation , gastroenterology
. Platelet transfusions from RhD‐positive (D‐positive) donors are often given to RhD‐negative (D‐negative) cancer patients. The low observed rate of alloimmunization has been attributed to disease and therapy‐related immunosuppression. We have studied the occurrence of alloimmunization in 16 D‐negative patients who did not have detectable anti‐D prior to autologous bone marrow transplantation for malignant disease. All received D‐positive platelets, but no other D‐positive blood product. Three patients (19%) developed anti‐D at 13, 24 and 83 days, respectively, after first receiving D‐positive platelets, and after a total dose of 53, 65 and 119 D‐positive platelet unit equivalents, respectively. Two of them also developed anti‐C. The 13 patients in whom anti‐D was not detected were also heavily transfused with D‐positive platelets (mean ± SD = 136 ± 82 platelet unit equivalents). In 6 of them, the last recorded antibody screen was less than 3 months after the first D‐positive platelets, and may not exclude a primary immune response. Thus, despite profound immunosuppression associated with autologous marrow transplantation, alloimmune responses to D‐positive red cells in platelet concentrates can occur in some D‐negative recipients.