Leukocyte depletion of random single-donor platelet transfusions does not prevent secondary human leukocyte antigen-alloimmunization and refractoriness: a randomized prospective study.
We studied the value of leukocyte depletion of platelet transfusions for the prevention of secondary human leukocyte antigen (HLA)-alloimmunization in patients with a high-risk of prior immunization induced by pregnancies. Seventy-five female patients with hematologic malignancies (mostly acute leukemia) and a history of pregnancy were randomized to receive either standard random single-donor platelet transfusions (mean leukocytes, 430 x 10(6) per transfusion) or leukocyte-depleted random single-donor platelet transfusions. Leukocyte depletion to less than 5 x 10(6) leukocytes per platelet transfusion (mean leukocytes, 2 x 10(6) per transfusion) was achieved by filtration. Of the 62 evaluable patients, refractoriness to random donor platelets occurred in 41% (14 of 34) of the patients in the standard group and in 29% (8 of 28) of the patients in the filtered group (P = .52); anti-HLA antibodies developed in 43% (9 of 21) of individuals in the standard group and 44% (11 of 25) of cases in the filtered group. The time toward refractoriness and development of anti-HLA antibodies was similar for both groups. We conclude that leukocyte depletion of random single-donor platelet products to less than 5 x 10(6) per transfusion does not reduce the incidence of refractoriness to random donor platelet transfusion because of boostering of anti-HLA antibodies.
Sintnicolaas
K
K
Department of Statistics, Dr Daniel den Hoed Cancer Center, Rotterdam, The Netherlands.
van Marwijk Kooij
M
M
van Prooijen
H C
HC
van Dijk
B A
BA
van Putten
W L
WL
Claas
F H
FH
Novotny
V M
VM
Brand
A
A
D000328:Adult; D000368:Aged; D005260:Female; D006680:HLA Antigens / Q000276:immunology; D006801:Humans; D007518:Isoantibodies / Q000097:blood*; D007519:Isoantigens / Q000276:immunology; D007938:Leukemia / Q000628:therapy*; D015470:Leukemia, Myeloid, Acute / Q000628:therapy; D007962:Leukocytes / Q000166:cytology* / Q000276:immunology; D015993:Life Tables; D008228:Lymphoma, Non-Hodgkin / Q000628:therapy*; D008875:Middle Aged; D009101:Multiple Myeloma / Q000628:therapy*; D009190:Myelodysplastic Syndromes / Q000628:therapy*; D017713:Platelet Transfusion; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy; D011247:Pregnancy; D011446:Prospective Studies
D006680:HLA Antigens; D007518:Isoantibodies; D007519:Isoantigens