Platelet transfusion refractoriness caused by a mismatch in HLA-C antigens

• Published in: Transfusion (Philadelphia, Pa.) Vol. 42; no. 3; pp. 302 - 308
• Main Authors: Saito, Satoshi, Ota, Satoshi, Seshimo, Hideyuki, Yamazaki, Yuichiro, Nomura, Setsuo, Ito, Toshihiro, Miki, Jun, Ota, Masao, Fukushima, Hirofumi, Maeda, Hiroo
• Format: Journal Article
• Language: English
• Published: Boston, MA, USA Blackwell Science Inc 01.03.2002; Blackwell Publishing
• Subjects: Adolescent; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood Group Incompatibility; Blood Platelets - immunology; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis; Child, Preschool; Female; Hematologic and hematopoietic diseases; Hematologic Neoplasms - blood; Hematologic Neoplasms - therapy; Histocompatibility; HLA-C Antigens - analysis; HLA-C Antigens - immunology; Humans; Isoantibodies - blood; Male; Medical sciences; Middle Aged; Other diseases. Hematologic involvement in other diseases; Platelet Count; Platelet Transfusion; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Treatment Outcome; Case study; Human; Prevention; Treatment resistance; Histocompatibility system; Platelet; Biochemical analysis; Transfusion; Monoclonal antibody; Diagnosis; Time variation
• ISSN: 0041-1132; 1537-2995
• DOI: 10.1046/j.1537-2995.2002.00051.x

BACKGROUND: HLA‐C antigens have been thought to be of little significance in determining the efficacy of platelet transfusions. However, six alloimmunized patients were encountered who were refractory to platelet transfusions because of anti‐HLA‐Cw3, ‐Cw7, or ‐Cw8. STUDY DESIGN AND METHODS: Between 1995 and the present, 88 patients with hematologic malignancies became refractory to random‐donor platelet transfusions due to HLA antibodies. HLA‐A‐ and HLA‐B‐compatible platelet transfusions were successful in boosting platelet levels with 82 of the patients. This study concerns the remaining six HLA‐immunized patients who were refractory to HLA‐A‐ and HLA‐B‐compatible platelet transfusions. The response to the platelet transfusions was assessed by calculating both 1‐ and 24‐hour posttransfusion CCIs for each transfusion. RESULTS: The average CCI1 hour and CCI24 hours in all patients were 20.0 and 12.8 for HLA‐A‐, HLA‐B‐, and HLA‐C‐compatible transfusions and were 1.4 and 1.2 for HLA‐A‐ and HLA‐B‐compatible but HLA‐C‐incompatible transfusions, respectively (p < 0.001). CONCLUSION: These findings clearly indicate that matching of the HLA‐C antigens is also required in some alloimmunized patients to obtain the effectiveness of platelet transfusions.