title: The role of alloantibodies against human platelet antigen-15 in multiply platelet transfused patients.
abstract: 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 Caucasian persons. However, the relevance of anti-HPA-15 in PTR among the Japanese population is still unclear.
  
  
  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 CD109 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.
  
  
  CONCLUSIONS
  In this study, we found alloimmunization against HPA-15a and -15b in Japanese populations and demonstrated the relevance of these antibodies in a patient with PTR.
authors.affiliation: Department of Transfusion Medicine, The University of Tokyo, Giessen, Germany; Analytical Laboratory Chemistry, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Mika
authors.initials: M
authors.lastname: Matsuhashi
authors.forename: Nelson H
authors.initials: NH
authors.lastname: Tsuno
authors.forename: Shinji
authors.initials: S
authors.lastname: Sone
authors.forename: Yuko
authors.initials: Y
authors.lastname: Mishima
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Nagura
authors.forename: Naoko
authors.initials: N
authors.lastname: Watanabe-Okochi
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Ikeda
authors.forename: Koichi
authors.initials: K
authors.lastname: Kashiwase
authors.forename: Shinya
authors.initials: S
authors.lastname: Fukuda
authors.forename: Takayuki
authors.initials: T
authors.lastname: Iriyama
authors.forename: Hironobu
authors.initials: H
authors.lastname: Hyodo
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yamashita
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Kamei
authors.forename: Shunya
authors.initials: S
authors.lastname: Arai
authors.forename: Mutsuhiko
authors.initials: M
authors.lastname: Minami
authors.forename: Tomoyuku
authors.initials: T
authors.lastname: Fujii
authors.forename: Mineo
authors.initials: M
authors.lastname: Kurokawa
authors.forename: Minoru
authors.initials: M
authors.lastname: Tozuka
authors.forename: Koki
authors.initials: K
authors.lastname: Takahashi
authors.forename: Sentot
authors.initials: S
authors.lastname: Santoso
mesh_terms: D000328:Adult; D015703:Antigens, CD / Q000276:immunology*; D016824:Antigens, Human Platelet / Q000276:immunology; D044466:Asian People; D001792:Blood Platelets / Q000276:immunology*; D002460:Cell Line; D015331:Cohort Studies; D005260:Female; D058851:GPI-Linked Proteins / Q000276:immunology; D006801:Humans; D007518:Isoantibodies / Q000276:immunology*; D009363:Neoplasm Proteins / Q000276:immunology*; D017713:Platelet Transfusion / Q000009:adverse effects; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000276:immunology; D012008:Recurrence; D013921:Thrombocytopenia / Q000276:immunology
chemical_list: D015703:Antigens, CD; D016824:Antigens, Human Platelet; C120523:CD109 protein, human; D058851:GPI-Linked Proteins; D007518:Isoantibodies; D009363:Neoplasm Proteins