Platelet and granulocyte alloimmunisation in multitransfused Tunisian patients

Abstract

We determined the frequency of post-transfusion alloimmunisation against platelet and granulocyte antigens in 51 Tunisian polytransfused patients with haematological diseases. Serum samples were analysed by a standard and an antiglobulin-augmented lymphocytotoxicity technique, a granulocyte agglutination test, a granulocyte immunofluorescence test, a platelet immunofluorescence test and the monoclonal antibody-specific immobilisation of platelet antigens assay. No granulocyte-specific antibodies were detected. HLA antibodies were found in 58.8% of patients. Platelet-specific antibodies were detected in four patients and were directed against human platelet antigen (HPA)-5b, HPA-1b and HPA-3a. The three patients with Glanzmann's thrombasthenia developed anti-GPIIb/IIIa antibodies. This study provides immunogenetic information that could improve the management of transfusion therapy in Tunisia.

Gene frequencies of the HPA-1 to -6 and -15 human platelet antigens in Tunisian blood donors

“…However, studies have mainly been performed in North American, European, and Oriental populations. In Tunisia, little is known about platelet immunogenetics and previous reports suggest that the frequency of platelet alloimmunization may differ with that seen in Whites and Asians (4–5). Tunisia is known to have a very heterogeneous population as a result of its history (6).…”

Platelet‐specific alloantigens and antibodies in Tunisian women after three or more pregnancies

“…Little is known about the distribution of HPA systems and platelet antibody frequencies in Tunisians. Previous studies have identified the anti‐HPA‐5b antibody as the most prevalent in multi‐transfused patients and in patients with NAIT, whereas anti‐HPA‐1a antibody–which is frequent in Whites (Murphy & Williamson, 2000; Ahya et al , 2001; Kjeldsen‐Kragh et al , 2007) – has not been found in Tunisians (Skouri et al , 2003, 2005).…”

Alloimmunization against platelets, granulocytes and erythrocytes in multi-transfused patients in Iranian population

“…Using leukodepleted blood will decrease alloimmunization rate against leukocytes but, because of their cost and sanctions in Iran, these types of human blood products are not always available. Several studies have reported that repeated transfusions led to the development of alloantibodies against the PLT or HLA antigens and different RBC blood group systems [14,16,17]. Despite the large number of nonleuko-depleted packed red cells and PLT concentrates transfused, 56.25% (135/240) of our multitransfused patients did not develop any allo-or auto-antibody, suggesting a degree of immune tolerance in these patients.…”

“…Despite the fact that alloantibodies are associated with transfusion risks, little is known about the extent and causes of these phenomena among patients with chronic hematologic diseases or the appropriate prevention methods [14]. There are no pertinent data on the number of multitransfused patients presenting platelet-or granulocytespecific antibodies especially in Iran.…”