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Minor impact of patient alloantibodies against human platelet antigen (HPA)‐15 in the effectiveness of platelet transfusion: A pilot study
Author(s) -
Inoue Hiroko,
Sakamoto Rumi,
Nishimiya Hiroko,
Sakamoto Hiroe,
Terasu Shota,
Aminaka Ryota,
Koh Yangsook,
Takihara Yoshihiro,
Hirayama Fumiya,
Kuroishi Ayumu
Publication year - 2021
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.16181
Subject(s) - medicine , abo blood group system , platelet , human leukocyte antigen , antibody , platelet transfusion , isoantibodies , immunology , titer , antigen , antibody titer , refractory (planetary science) , gastroenterology , physics , astrobiology
Background Alloantibodies against human platelet antigen (HPA)‐15 are sometimes detected in patients with platelet transfusion refractoriness (PTR); however, little is known about their impact on PTR. Study Design and Methods Two patients who possessed HPA‐15 alloantibodies (Patient 1, anti‐HPA‐15b; Patient 2, anti‐HPA‐15a) and human leukocyte antigen (HLA) antibodies were enrolled. The efficacy of HPA‐15–compatible vs –incompatible platelet transfusion was compared by focusing on ABO‐ and HLA‐matched transfusions on the basis of the 24‐hour corrected count increment (CCI‐24 hours) for platelets. The titers of HPA‐15 antibodies in the patients' sera were also monitored. Results The patients received 71 and 12 ABO‐compatible, HLA‐matched platelet transfusions, respectively, during the monitoring periods. Among these transfusions, CCI‐24 hours could be calculated in 27 and 10 transfusions, respectively, and the HPA‐15 genotype of the donors was determined. There were no significant differences in the CCI‐24 hours between the HPA‐15 compatible and incompatible transfusions in both patients ( P = .30 and .56, respectively, Mann‐Whitney U test). There was no significant change in the HPA‐15b antibody titer in Patient 1 during the monitoring period, while the HPA‐15a antibody level in Patient 2 was undetectable at the end of the monitoring period, although the titer was low at the beginning. Conclusion The efficacy of HPA‐15–incompatible platelet transfusions was not necessarily inferior to that of HPA‐15 compatible ones. Although the case number was limited, our results suggest that HPA‐15 antibodies do not have a significant impact on the effects of platelet transfusion.