BackgroundImmune platelet refractoriness is mainly caused by human leukocyte antigen
antibodies (80-90% of cases) and, to a lesser extent, by human platelet antigen
antibodies. Refractoriness can be diagnosed by laboratory tests and patients
should receive compatible platelet transfusions. A fast, effective and low cost
antibody-screening method which detects platelet human leukocyte/platelet antigen
antibodies is essential in the management of immune platelet refractoriness. ObjectiveThe aim of this study was to evaluate the efficiency of the flow cytometry
platelet immunofluorescence test to screen for immune platelet refractoriness.
MethodsA group of prospective hematologic patients with clinically suspected platelet
refractoriness treated in a referral center in Campinas, SP during July 2006 and
July 2011 was enrolled in this study. Platelet antibodies were screened using the
flow cytometry platelet immunofluorescence test. Anti-human leukocyte antigen
antibodies were detected by commercially available methods. The sensitivity,
specificity and predictive values of the immunofluorescence test were determined
taking into account that the majority of antiplatelet antibodies presented human
leukocyte antigen specificity. ResultsSeventy-six samples from 32 female and 38 male patients with a median age of 43.5
years (range: 5-84 years) were analyzed. The sensitivity of the test was 86.11%
and specificity 75.00% with a positive predictive value of 75.61% and a negative
predictive value of 85.71%. The accuracy of the method was 80.26%. ConclusionThis study shows that the flow cytometry platelet immunofluorescence test has a
high correlation with the anti-human leukocyte antigen antibodies. Despite a few
limitations, the method seems to be efficient, fast and feasible as the initial
screening for platelet antibody detection and a useful tool to crossmatch
platelets for the transfusional support of patients with immune platelet
refractoriness.
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