Efficacy of HLA‐matched platelet transfusions for patients with hypoproliferative thrombocytopenia: a systematic review

Abstract

The correlation of the PLT increment with other clinical outcomes and the effect of leukoreduction on HLA-matched PLT transfusion could not be determined. Prospective studies utilizing current technology and examining clinical outcomes are necessary to demonstrate the effectiveness of HLA-matched PLT transfusion.

Guidance on Platelet Transfusion for Patients With Hypoproliferative Thrombocytopenia

“…In the context of this document, HLA crossmatched platelets are platelets that have had in vitro crossmatching performed vs platelets that are selected to be antigen negative for any patient HLA antibodies. There were 5 studies [24] that compared some of these methods. However, no definite inferences can be made as to the superiority of one method compared to the others.…”

“…The effect of HLA selection appeared less evident in studies that used leukoreduced products compared to studies involving nonleukoreduced platelets (Appendix A, Supplementary Tables S15 and S16). There was no benefit of using HLA selection to reduce alloimmunization rates and refractoriness beyond the use of leukoreduced platelets in nonrefractory patients [24].…”

“…One RCT and 29 nonrandomized studies of 1600 patients comprised the systematic review [24]. Most studies did not include technologies currently in use for HLA typing or detection of HLA class I antibodies implicated, as 75% were conducted before the year 2000.…”

“…Three published systematic reviews were included [21][22][23], and 5 systematic reviews were conducted by the ICTMG. Two [24,25] of the 5 conducted systematic reviews are published as full articles. Two [21,23] of the 8 systematic reviews included mainly randomized controlled trials, whereas 4 had mostly nonrandomized studies, for example, ABO matching, HLA matching, and crossmatching for platelet transfusions [22,24,25] and use of Rh immunoglobulin.…”

Efficacy of HLA virtual cross‐matched platelet transfusions for platelet transfusion refractoriness in hematopoietic stem cell transplantation

“…However, a cross‐matched PLT is more expensive and requires greater effort than a standard PLT for physical cross‐match. A recent report attests to the utility of virtual HLA cross‐matched PLT (HLA‐matched PLT) that is defined as HLA‐A/B matched or excludes cross‐reactive groups …”