Platelet alloimmunization after multiple transfusions: a prospective study of 50 patients.
Fifty polytransfused patients were prospectively studied to determine the frequency of post-transfusion alloimmunization and its influence on the response to platelet transfusion. Platelet- and HLA-specific antibodies were detected by means of the standard and antiglobulin-augmented lymphocytotoxicity techniques (LCT), the platelet suspension indirect immunofluorescence test (PSIIFT), and monoclonal antibody immobilization of platelet antigens (MAIPA). HLA antibodies were detected in 13 patients (26%) (IgM = 6; IgG = 6; IgM + IgG = 1). The standard LCT was positive in 12 of these 13 patients. Complement-independent HLA antibodies, only detectable in the PSIIFT and the antiglobulin-augmented LCT, were documented in two patients and were associated with poor post-transfusion platelet recovery in the patient who could be evaluated. All the HLA antibodies were detected in the PSIIFT, while only four were detected in the MAIPA. Platelet-specific alloantibodies were found in two patients by means of PSIIFT or MAIPA and may have led to poor post-transfusion platelet recovery in one patient. Platelet autoantibodies were detected in two patients but were not associated with platelet refractoriness. Paraformaldehyde-dependent platelet antibodies were detected in 11 patients but were not associated with platelet refractoriness.
Godeau
B
B
Laboratoire d'immunologie leuco-plaquettaire, Hôpital Henri Mondor, Créteil, France.
Fromont
P
P
Seror
T
T
Duedari
N
N
Bierling
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000276:immunology; D001792:Blood Platelets / Q000276:immunology*; D001803:Blood Transfusion; D002648:Child; D005260:Female; D005455:Fluorescent Antibody Technique; D006680:HLA Antigens / Q000032:analysis / Q000276:immunology; D006801:Humans; D007114:Immunization; D007074:Immunoglobulin G / Q000032:analysis / Q000276:immunology; D007075:Immunoglobulin M / Q000032:analysis / Q000276:immunology; D007518:Isoantibodies / Q000032:analysis* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013921:Thrombocytopenia / Q000276:immunology
D000911:Antibodies, Monoclonal; D006680:HLA Antigens; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D007518:Isoantibodies