Delayed alloimmunization using random single donor platelet transfusions: a prospective study in thrombocytopenic patients with acute leukemia

Abstract

A randomized study was performed in 54 thrombocytopenic patients with acute leukemia. Alloimmunization of recipients of random multiple-donor platelet concentrates (MD group) was compared to that of patients receiving random single-donor platelets (SD group). In the SD patients, formation of alloantibodies (mostly anti-HLA) occurred less frequently (p less than 0.002), after a longer time period (p less than 0.002), and after a higher number of transfusions (p less than 0.005) as compared to MD patients. SD patients also became refractory to random platelets less frequently (p less than 0.005), after a longer time period, and after a higher number of transfusions (p less than 0.02). In SD patients, the increments after the first and the last transfusion were in the same range, whereas in MD patients, the 1-hr (p less than 0.001) and the 24-hr (p less than 0.025) increments decreased from the first to the last transfusion. Thus, the use of random SD platelet transfusions postponed alloimmunization.

Factors influencing yield of plateletpheresis using intermittent flow cell separator

“…This trend has resulted from the observations that SDPs Pearson correlation indicates good correlation between predonation platelet count and yield for all procedures (r ¼ 0.51, P < 0.001). are a better platelet product due to less donor exposures and consequent reduction in transfusion transmitted diseases (Goodnough et al, 1999a,b), transfusion reactions (Chambers et al, 1990) and possibly alloimmunization (Gmur et al, 1983). Currently, more than 50% of platelets are produced by plateletpheresis in developed countries (Wallace et al, 1998).…”

HLA alloimmunization against platelet transfusions: pathophysiology, significance, prevention and management

“…using only single-donor platelets, prophylactic HLA-matching, and leukoreduction or irradiation of cellular blood products. The use of prophylactic single-donor platelets to reduce HLA alloimmunization by reducing foreign antigen exposure was examined in several clinical studies (36,37) including a prospective randomized trial (38). While some studies supported such practice, others failed to show a consistent benefit and the practice is not generally recommended.…”

Antibodies to human platelet antigens form a significant proportion of platelet antibodies detected in Indian patients with refractoriness to platelet transfusions

“…We did not find a statistically significant association between the number of cellular transfusions and alloimmunisation (P = 0·38). Most transfusion trials on humans suggest that there is a dose-response relationship between the number of exposures and the risk of alloimmunisation (Gmur et al, 1983). However, there was an absence of dose-response relationships for the development of alloantibodies by a study conducted by (Dutcher et al (1981) The study also demonstrated that the rate of immunisation is independent of the number of platelet units transfused.…”