Effectiveness of crossmatched or HLA-platelets vs. random platelets for refractory patients

Rioux-Massé et al from University of Minnesota Medical Center report in the December 2014 issue of Transfusion (abstract) a retrospective study of 32 patients who had laboratory confirmation of immune-mediated PLT refractoriness, and received platelet transfusion with crossmatched or HLA-matched PLTs.   Immune-mediated refractoriness was called "positive" when a PLT crossmatch was incompatible with at least 1 unit or an HLA antibody screen detected HLA Class I antibody against any number of antigens in a single-well test system.  The HLA antibody avoidance technique was not used by the blood supplier, ARC Mid-America Blood Services Division.  Finally, PLTs were either ABO-identical or -compatible. Out of 354 total PLT transfusions, 45% were random-donor apheresis PLTs, 42% were crossmatched PLTs, and 13% were HLA-matched.  Using a CCI of 5.0 X 109/L as defining a satisfactory response to PLT transfusion, the rates of satisfactory responses for random-donor units was 13%, for crossmatched PLTs 25%, and HLA-matched PLTs 29%.  There was no statistically significant differences in the frequency of satisfactory transfusion between the different PLT products, although this study was probably not adequately powered to detect any true differences.  One of the interesting, albeit frustrating, things about this study is how miserably crossmatched PLT and HLA-matched platelets performed overall. The authors did not correlate the...
Source: The Daily Sign-Out - Category: Cancer & Oncology Authors: Tags: Platelet Transfusion Source Type: blogs