title: Low frequency of anti-D alloimmunization following D+ platelet transfusion: the Anti-D Alloimmunization after D-incompatible Platelet Transfusions (ADAPT) study.
abstract: The reported frequency of D alloimmunization in D- recipients after transfusion of D+ platelets varies. This study was designed to determine the frequency of D alloimmunization, previously reported to be an average of 5 ± 2%. A primary anti-D immune response was defined as the detection of anti-D ≥ 28 d following the first D+ platelet transfusion. Data were collected on 485 D- recipients of D+ platelets in 11 centres between 2010 and 2012. Their median age was 60 (range 2-100) years. Diagnoses included: haematological (203/485, 42%), oncological (64/485, 13%) and other diseases (218/485, 45%). Only 7/485 (1·44%; 95% CI 0·58-2·97%) recipients had a primary anti-D response after a median serological follow-up of 77 d (range: 28-2111). There were no statistically significant differences between the primary anti-D formers and the other patients, in terms of gender, age, receipt of immunosuppressive therapy, proportion of patients with haematological/oncological diseases, transfusion of whole blood-derived or apheresis platelets or both, and total number of transfused platelet products. This is the largest study with the longest follow-up of D alloimmunization following D+ platelet transfusion. The low frequency of D alloimmunization should be considered when deciding whether to administer Rh Immune Globulin to D- males and D- females without childbearing potential after transfusion of D+ platelets.
authors.affiliation: Department of Haemotherapy and Haemostasis, Hospital Clínic, IDIBAPS, UB, Barcelona, Spain; Clinical Center, Department of Transfusion Medicine, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Joan
authors.initials: J
authors.lastname: Cid
authors.forename: Miguel
authors.initials: M
authors.lastname: Lozano
authors.forename: Alyssa
authors.initials: A
authors.lastname: Ziman
authors.forename: Kamille A
authors.initials: KA
authors.lastname: West
authors.forename: Kerry L
authors.initials: KL
authors.lastname: O'Brien
authors.forename: Michael F
authors.initials: MF
authors.lastname: Murphy
authors.forename: Silvano
authors.initials: S
authors.lastname: Wendel
authors.forename: Alejandro
authors.initials: A
authors.lastname: Vázquez
authors.forename: Xavier
authors.initials: X
authors.lastname: Ortín
authors.forename: Tor A
authors.initials: TA
authors.lastname: Hervig
authors.forename: Meghan
authors.initials: M
authors.lastname: Delaney
authors.forename: Willy A
authors.initials: WA
authors.lastname: Flegel
authors.forename: Mark H
authors.initials: MH
authors.lastname: Yazer
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology; D000293:Adolescent; D000328:Adult; D000368:Aged; D001787:Blood Group Incompatibility / Q000453:epidemiology / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007518:Isoantibodies / Q000096:biosynthesis*; D008297:Male; D008875:Middle Aged; D010298:Parity; D017713:Platelet Transfusion / Q000009:adverse effects*; D010983:Plateletpheresis; D011247:Pregnancy; D012189:Retrospective Studies; D012204:Rh-Hr Blood-Group System / Q000276:immunology; D018029:Rho(D) Immune Globulin; D055815:Young Adult
chemical_list: D000017:ABO Blood-Group System; D007518:Isoantibodies; C061961:RHO(D) antibody; D012204:Rh-Hr Blood-Group System; D018029:Rho(D) Immune Globulin
keywords: D compatibility; RhIG; alloimmunization; anti-D alloantibodies; platelet transfusion