Alloimmunization to D antigen and HLA in D‐negative immunosuppressed oncology patients

Baldwin, Michael; Ness, Paul M.; Scott, D.; Braine, Hayden G.; Kickler, Thomas S.

doi:10.1046/j.1537-2995.1988.28488265260.x

Cited by 61 publications

(51 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Lichtiger et al postulated that the more intense chemotherapeutic regimens available in the early 1980s impaired the response to D antigen presentation 5 . However, Baldwin et al 3 found when reviewing the records of D− oncology patients transfused between 1979 and 1983 that 18 percent of those given a combination of pooled whole blood‐derived platelet concentrates and apheresis platelets containing 2.6 to 481.2 mL RBCs from D+ donors developed anti‐D. Thirty‐two percent of these patients developed HLA alloimmunization.…”

mentioning

confidence: 99%

Immunoprophylaxis for D− patients receiving platelet transfusions from D−donors?

Menitove

2002

Transfusion

View full text Add to dashboard Cite

mentioning

confidence: 99%

Immunoprophylaxis for D− patients receiving platelet transfusions from D−donors?

Menitove

2002

Transfusion

View full text Add to dashboard Cite

“…Some authors reported no incidence of anti-D alloimmunization in this group of patients [84,86,87,90,91,92,93,94,95]; other authors, however, reported an incidence of anti-D alloimmunization that ranged from 2.7 to 18.7% [83,88,89,108]. …”

Section: Part 2: Plt Transfusion and The D Antigenmentioning

confidence: 88%

“…If we exclude those patients, the percentage of D alloimmunization varies as shown in table 3. Overall, the incidence of D alloimmunization in immunosuppressed patients after D incompatible platelet transfusions is reported to be between 0 and 19% [83,84,85,86,87,88,89,90,91,92,93,94], but keeping some recently published data in mind [95], we can conclude that the frequency of anti-D alloimmunization actually ranges between 0 and 6.8% [96]. …”

Section: Part 2: Plt Transfusion and The D Antigenmentioning

confidence: 95%

“…In some of the reports on D alloimmunization after D incompatible PLT transfusion, the percentage of ABO incompatible transfusions is provided; it ranges between 43 and 90% (table 3) [84,87,88,91,93,95]. Thus, the protective effect associated with the transfusion of ABO and D mismatched RBCs is unlikely to be seen in current clinical practice given the high incidence of ABO matched transfusions in the studies reported [99].…”

Section: Part 2: Plt Transfusion and The D Antigenmentioning

confidence: 99%

See 1 more Smart Citation

Platelet Transfusion - the Art and Science of Compromise

Cid

Harm

Yazer

2013

Transfus Med Hemother

View full text Add to dashboard Cite

Many modern therapies depend on platelet (PLT) transfusion support. PLTs have a 4- to 7-day shelf life and are frequently in short supply. In order to optimize the inventory PLTs are often transfused to adults without regard for ABO compatibility. Hemolytic reactions are infrequent despite the presence of ‘high titer' anti-A and anti-B antibodies in some of the units. Despite the low risk for hemolysis, some centers provide only ABO identical PLTs to their recipients; this practice might have other beneficial outcomes that remain to be proven. Strategies to mitigate the risk of hemolysis and the clinical and laboratory outcomes following ABO-matched and mismatched transfusions will be discussed. Although the PLTs themselves do not carry the D antigen, a small number of RBCs are also transfused with every PLT dose. The quantity of RBCs varies by the type of PLT preparation, and even a small quantity of D+ RBCs can alloimmunize a susceptible D- host. Thus PLT units are labeled as D+/-, and most transfusion services try to prevent the transfusion of D+ PLTs to D- females of childbearing age. A similar policy for patients with hematological diseases is controversial, and the elements and mechanisms of anti-D alloimmunization will be discussed.

show abstract

“…As ABO antigens are present on platelets, it is preferable to transfuse with ABO compatible platelets [34,37,38]. The concomitant administration of at least 250 IU of anti-D is recommended in case of transfusion of Rh(D) positive platelets to a Rh(D) negative patient to prevent Rh D alloimmunization [39][40][41][42]. Apheresis platelets are recommended to prevent HLA alloimmunisation and platelet refractoriness in patients who require prolonged platelet support [43][44][45][46][47][48].…”

Section: Platelet Transfusionsmentioning

confidence: 99%

Appropriate blood component usage

Koh

Lee

Chay

2011

ISBT Science Series

View full text Add to dashboard Cite

Blood transfusion (which includes FFP, platelets, cryoprecipitate and any other blood-derived product) remains an important modality of treatment across all clinical disciplines. A blood transfusion is deemed appropriate when used in an evidence-based fashion and where the effects of the transfusion are felt to outweigh any potential risks and complications that may arise from the transfusion. In certain cases, it may be the best treatment option available, for example plasma exchange in thrombotic thrombocytopenic purpura. However, blood transfusion can result in acute or delayed complications, as well as the risk of transmission of infectious agents. The inappropriate use of blood and blood products increases the risk of transfusion-related complications and adverse events to recipients. It also contributes to shortages of blood products and the possibility of it not being available when required for other patients in an appropriate setting. It is therefore necessary to reduce the unnecessary transfusions through the appropriate clinical use of blood, avoiding unnecessary transfusions, and use of alternatives to transfusion.Key words: clinical transfusion, fresh frozen plasma, guidelines, platelets, red cell, transfusion trigger. MethodsWe conducted a literature review via Pubmed and selected the articles relevant to our review and published in English or with translations provided in English. RecommendationsThese are based on the current available data; in situations where there is lack of randomized data, published reports or recommendations from previous experiences are used. Red cells transfusionThe aim of red cell transfusion is to increase oxygen carrying capacity of blood by increasing haemoglobin concentration in patients with acute or chronic anaemia.The decision to transfuse red cells should be carefully weighed on an individual basis, taking into consideration clinical evaluation of symptoms and haemodynamic status as well as laboratory parameters such as haemoglobin level. It is more relevant to consider the goal of red cell transfusion as the avoidance of tissue hypoxia rather than the correction of a laboratory parameter. In general, patients should not be transfused so as to achieve 'normal' haemoglobin (Hb) concentration [1,2]. Packed red cells should generally be provided for allogeneic transfusion where possible [3,4]. Packed red cells are preferred over whole blood to reduce the volume of transfusion and avoid the white cells ⁄ plasma that can potentially cause more febrile reaction and HLA sensitization, etc. Transfusion trigger?There is no standard fixed trigger for red cell transfusion. The trigger for transfusion should always be evaluated in the context of a multiplicity of factors including rate and amount of blood loss, cardiopulmonary reserve. The rate of development of anaemia is also an important factor.

show abstract

Alloimmunization to D antigen and HLA in D‐negative immunosuppressed oncology patients

Cited by 61 publications

References 6 publications

Immunoprophylaxis for D− patients receiving platelet transfusions from D−donors?

Immunoprophylaxis for D− patients receiving platelet transfusions from D−donors?

Platelet Transfusion - the Art and Science of Compromise

Appropriate blood component usage

Contact Info

Product

Resources

About