Platelet transfusion therapy. One-hour posttransfusion increments are valuable in predicting the need for HLA-matched preparations.
Seventy-nine platelet transfusions to 73 thrombocytopenic patients with cancer were analyzed to determine whether a platelet count obtained one hour after transfusion could help differentiate between alloimmunization and other clinical factors that result in rapid platelet destruction. These transfusions were selected because 18- to 24-hour increments were inadequate in response to fresh, random donor platelets. A corrected count increment (Cl) (Cl=[posttransfusion count-pretransfusion count]Xbody surface area [sq m]/platelets transfusedX10'') at one hour of 10X103/microliter or greater was associated with absence of lymphocytotoxic antibody, whereas increments of less than 10X103/microliter were generally associated with high levels of strongly cytotoxic antibody. HLA-matched transfusions produced no improvement in increments when the previous one-hour Cl had been 10X103/microliter or greater, whereas in the other group significantly better increments were obtained. A one-hour posttransfusion count is a simple test that correlates well with the presence of antibody against HLA antigens, is valuable in predicting the need for HLA-matched platelets, and helps avoid wasteful, empirical use of such transfusions.
D000328:Adult; D000961:Antilymphocyte Serum / Q000032:analysis; D001788:Blood Grouping and Crossmatching; D001792:Blood Platelets / Q000276:immunology; D001803:Blood Transfusion; D003601:Cytotoxicity Tests, Immunologic; D006680:HLA Antigens / Q000276:immunology; D006648:Histocompatibility; D006801:Humans; D009369:Neoplasms / Q000150:complications; D017713:Platelet Transfusion; D013921:Thrombocytopenia / Q000209:etiology / Q000628:therapy
D000961:Antilymphocyte Serum; D006680:HLA Antigens