title: Prevalence of platelet-specific antibodies and efficacy of crossmatch-compatible platelet transfusions in refractory patients.
abstract: BACKGROUND
  The development of specific antibodies against human leukocyte antigen (HLA) and/or human platelet antigen (HPA) could induce platelet transfusion refractoriness especially in patients receiving multiple platelet transfusions. A retrospective analysis was conducted to evaluate the prevalence of platelet-specific antibodies and the efficacy of crossmatch-compatible platelet transfusions in these recipients.
  
  
  METHODS
  All enrolled patients were refractory to random single-donor apheresis Platelet (PLT) units. Enzyme-linked immunosorbent assay (ELISA) was used to detect anti-HLA and anti-HPA antibodies in serum. For those patients with antibodies, the PLT crossmatch assays were performed to select the compatible PLTs with a commercial solid-phase adherence kit.
  
  
  RESULTS
  A total of 193 patients were included and 29.02% of which was HLA and/or HPA antibody-positive. There were no significant differences in antibody-positive rates among AML/CML, ALL/CLL, MDS, SAA and ITP groups, but they are statistically significantly higher than other groups (P = 0.0035). Of those antibody-positive patients, there were 41 (73.21%) patients with only HLA antibodies, 11 (19.64%) patients with only HPA antibodies and 4 (7.14%) patients with both HLA and HPA antibodies. A total of 43 random PLT units and 88 crossmatch-compatible PLT units were administered. The mean (± SD) corrected count increment (CCI) was 8700 (± 4500) after crossmatch-compatible unit transfusion, significantly higher than 3600 (± 2400) for random PLT units (P < 0.001).
  
  
  CONCLUSIONS
  HLA and/or HPA alloimmunisation is an important factor to cause refractoriness to platelet transfusions. Crossmatch-compatible platelet transfusion is an effective method in those patients refractory to random platelet transfusions.
authors.affiliation: Department of HLA, Beijing Red Cross Blood Center, Beijing, P. R. China.
authors.forename: Y
authors.initials: Y
authors.lastname: Jia
authors.forename: W
authors.initials: W
authors.lastname: Li
authors.forename: N
authors.initials: N
authors.lastname: Liu
authors.forename: K
authors.initials: K
authors.lastname: Zhang
authors.forename: Z
authors.initials: Z
authors.lastname: Gong
authors.forename: D
authors.initials: D
authors.lastname: Li
authors.forename: L
authors.initials: L
authors.lastname: Wang
authors.forename: D
authors.initials: D
authors.lastname: Wang
authors.forename: Y
authors.initials: Y
authors.lastname: Jing
authors.forename: J
authors.initials: J
authors.lastname: Wang
authors.forename: X
authors.initials: X
authors.lastname: Shan
mesh_terms: D000328:Adult; D000368:Aged; D016824:Antigens, Human Platelet / Q000276:immunology*; D001788:Blood Grouping and Crossmatching; D005260:Female; D006680:HLA Antigens / Q000276:immunology*; D006801:Humans; D007518:Isoantibodies / Q000097:blood* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D017713:Platelet Transfusion / Q000009:adverse effects*; D015995:Prevalence; D012189:Retrospective Studies
chemical_list: D016824:Antigens, Human Platelet; D006680:HLA Antigens; D007518:Isoantibodies
keywords: platelet transfusion refractoriness; platelet-specific antibodies