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Prevalence of platelet‐specific antibodies and efficacy of crossmatch‐compatible platelet transfusions in refractory patients
Author(s) -
Jia Y.,
Li W.,
Liu N.,
Zhang K.,
Gong Z.,
Li D.,
Wang L.,
Wang D.,
Jing Y.,
Wang J.,
Shan X.
Publication year - 2014
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 - 10.1111/tme.12157
Subject(s) - medicine , platelet , antibody , platelet transfusion , refractory (planetary science) , human leukocyte antigen , apheresis , immunology , isoantibodies , antigen , plateletpheresis , gastroenterology , biology , astrobiology
SUMMARY Background The development of specific antibodies against human leukocyte antigen ( HLA ) and/or human platelet antigen ( HPA ) could induce platelet transfusion refractoriness especially in patients receiving multiple platelet transfusions. A retrospective analysis was conducted to evaluate the prevalence of platelet‐specific antibodies and the efficacy of crossmatch‐compatible platelet transfusions in these recipients. Study Design and Methods All enrolled patients were refractory to random single‐donor apheresis Platelet ( PLT ) units. Enzyme‐linked immunosorbent assay ( ELISA ) was used to detect anti‐ HLA and anti‐ HPA antibodies in serum. For those patients with antibodies, the PLT crossmatch assays were performed to select the compatible PLTs with a commercial solid‐phase adherence kit. Results A total of 193 patients were included and 29·02% of which was HLA and/or HPA antibody‐positive. There were no significant differences in antibody‐positive rates among AML / CML , ALL / CLL , MDS , SAA and ITP groups, but they are statistically significantly higher than other groups ( P = 0·0035). Of those antibody‐positive patients, there were 41 (73·21%) patients with only HLA antibodies, 11 (19·64%) patients with only HPA antibodies and 4 (7·14%) patients with both HLA and HPA antibodies. A total of 43 random PLT units and 88 crossmatch‐compatible PLT units were administered. The mean (± SD ) corrected count increment ( CCI ) was 8700 (±4500) after crossmatch‐compatible unit transfusion, significantly higher than 3600 (±2400) for random PLT units ( P < 0·001). Conclusions HLA and/or HPA alloimmunisation is an important factor to cause refractoriness to platelet transfusions. Crossmatch‐compatible platelet transfusion is an effective method in those patients refractory to random platelet transfusions.