Details

Autor(en) / Beteiligte

• Kiefel, Volker
• König, Claudia
• Kroll, Hartmut
• Santoso, Sentot

Titel

Platelet alloantibodies in transfused patients

Ist Teil von

• Transfusion (Philadelphia, Pa.), 2001-06, Vol.41 (6), p.766-770

Ort / Verlag

Oxford, UK: Blackwell Science Inc

Erscheinungsjahr

2001

Quelle

Wiley

Beschreibungen/Notizen

• BACKGROUND: Patients receiving cellular blood components may form HLA antibodies and platelet‐specific alloantibodies. STUDY DESIGN AND METHODS: Serum samples from a cohort of 252 patients with hematologic or oncologic diseases who are receiving cellular blood components were studied for platelet‐reactive antibodies. Specificity of platelet alloantibodies was determined with a panel of typed platelets RESULTS: Platelet‐reactive antibodies were detected in the sera of 113 patients (44.8% of 252), HLA antibodies in the sera of 108 (42.9%), and platelet‐specific antibodies in the sera of 20 (8%). The following platelet‐specific antibodies were identified: anti‐HPA‐5b (n = 10), anti‐HPA‐1b (n = 4), anti‐HPA‐5a (n = 2), anti‐HPA‐1a (n = 1), anti‐HPA‐2b (n = 1), anti‐HPA‐1b+5b (n = 1), and anti‐HPA‐1b+2b (n = 1). Fifteen sera from the 108 patients with anti‐HLA (13.9%) contained additional platelet‐specific alloantibodies, while in 5 sera, platelet‐specific alloantibodies only were detected: anti‐HPA‐5b (n = 4) and anti‐HPA‐1a (n = 1). Of the 108 sera with HLA antibodies, 29 (26.9%) showed discordant results when studied with the lymphocytotoxicity test and the glycoprotein‐specific immunoassay. Ten sera contained panreactive antibodies against platelet glycoproteins (GP) IIb/IIIa, GPIa/IIa, and/or GPIb/IX. Alloimmunization occurred in 58.3 percent of female patients with previous pregnancies, but in only 23.3 percent of those without previous pregnancies (p = 0.0049). CONCLUSION: Platelet alloantibody specificities in transfused patients (predominantly anti‐HPA‐5b and ‐1b with antigen frequencies <30% among whites) differ significantly from those observed in patients with neonatal alloimmune thrombocytopenia or posttransfusion purpura, in whom anti‐HPA‐1a (antigen frequency >95%) is the most prevalent specificity. HLA antibody detection yields discordant results when the lymphocytotoxicity assay and a glycoprotein‐specific immunoglobulin‐binding assay are used.