Absence of anti-D alloimmunization in hematologic patients after D-incompatible platelet transfusions

• Published in: Transfusion (Philadelphia, Pa.) Vol. 42; no. 2; pp. 173 - 176
• Main Authors: Cid, Joan, Ortin, Xavier, Elies, Enric, Castellà, Dolors, Panadés, Marta, Martín-Vega, Carmen
• Format: Journal Article
• Language: English
• Published: Boston, MA, USA Blackwell Publishing, Inc 01.02.2002; Blackwell Publishing
• Subjects: Acute Disease; Adult; Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood Group Incompatibility; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis; Erythrocytes - immunology; Female; Humans; Immunosuppression; Isoantibodies - blood; Leukemia - therapy; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - therapy; Lymphoma, Non-Hodgkin - therapy; Male; Medical sciences; Middle Aged; Myelodysplastic Syndromes - therapy; Platelet Transfusion - adverse effects; Prospective Studies; Rh-Hr Blood-Group System - immunology; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Case study; Human; Incompatibility; Isoimmunization; Blood concentration; Transfusion; Risk factor; Rh-System; Concentrate; Malignant tumor
• ISSN: 0041-1132; 1537-2995
• DOI: 10.1046/j.1537-2995.2002.00038.x

BACKGROUND: Rh antigens are not present on the platelet surface. However, platelet concentrates may contain enough RBCs to elicit an anti‐D response. Thus, D status must be considered in platelet transfusion. In immunosuppressed patients, frequencies of D alloimmunization of up to 19 percent have been previously reported. STUDY DESIGN AND METHODS: Here a prospective study is reported in which 22 D– patients with hematologic disease received D+ platelet transfusions. Platelet concentrates were prepared from whole‐blood donations according to the buffy coat method and were pooled before administration. The antibody screen test to detect anti‐D was performed by LISS‐ IAT using the gel test. RESULTS: Our series comprises 22 immunosuppressed D+ patients with a median age of 56 years (range, 23–79). The patients received 121 D‐incompatible pooled platelet transfusions. The mean ± SD of RBC content was 4.17 ± 1.74 mL. None of the 22 patients developed detectable anti‐D after a median follow‐up of 8 weeks (range, 1–37). CONCLUSION: The risk of D alloimmunization is low in patients with hematologic disease after D‐incompatible platelet transfusions using platelet concentrates prepared by the buffy coat method.