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The role of alloantibodies against human platelet antigen‐15 in multiply platelet transfused patients
Author(s) -
Matsuhashi Mika,
Tsuno Nelson H.,
Sone Shinji,
Mishima Yuko,
Nagura Yutaka,
WatanabeOkochi Naoko,
Ikeda Toshiyuki,
Kashiwase Koichi,
Fukuda Shinya,
Iriyama Takayuki,
Hyodo Hironobu,
Yamashita Takahiro,
Kamei Yoshimasa,
Arai Shunya,
Minami Mutsuhiko,
Fujii Tomoyuku,
Kurokawa Mineo,
Tozuka Minoru,
Takahashi Koki,
Santoso Sentot
Publication year - 2014
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.12455
Subject(s) - neonatal alloimmune thrombocytopenia , medicine , immunology , antibody , platelet , antigen , human leukocyte antigen , isoantibodies , clinical significance , population , aplastic anemia , biology , bone marrow , pregnancy , fetus , genetics , environmental health
Background Several studies have documented the role of antibodies against human platelet ( PLT ) antigen ( HPA )‐15 in alloimmune‐mediated thrombocytopenia including neonatal alloimmune thrombocytopenia, PLT transfusion refractoriness ( PTR ), and posttransfusion purpura in C aucasian persons. However, the relevance of anti‐ HPA ‐15 in PTR among the J apanese population is still unclear. Study Design and Methods The sera of 305 multiply PLT transfused ( MPT ) patients, previously investigated for the presence of human leukocyte antigen ( HLA ) and HPA antibodies by mixed passive hemagglutination, were reexamined for the presence of HPA ‐15 alloantibodies, using the monoclonal antibody–specific immobilization of PLT antigens ( MAIPA ) technique. Results Among the 305 MPT samples, antibodies against HPA ‐15 alloantigen was detected in seven (2.3%), two (0.66%) being anti‐ HPA ‐15a and five (1.64%) being anti‐ HPA ‐15b. Additionally, one case of CD 109 panreactive antibody was found (0.33%). Among them, one aplastic anemia patient with blood group O developed multispecific anti‐ HLA and anti‐ HPA ‐15b alloantibody after MPTs . However, transfusion with HLA ‐matched PLTs of blood group AB did not result in adequate PLT count increment. Analysis of the possible influence of immune anti‐ A and anti‐ B by the MAIPA assay resulted negative, indicating that anti‐ HPA ‐15b is responsible for the refractory state in this patient. Conclusion In this study, we found alloimmunization against HPA ‐15a and ‐15b in J apanese populations and demonstrated the relevance of these antibodies in a patient with PTR .