| Frequency and causes of refractoriness in multiply transfused patients. | |
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MedLine Citation:
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PMID: 9174547 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The use of leukocyte-depleted blood components has become the standard therapy for multiply transfused patients during the past few years, as a measure to reduce the frequency of alloimmunization and refractoriness. We assessed frequency and causes of refractoriness, defined as a repeated 24-h post-transfusion platelet count below 20,000/microliters, in 145 consecutive patients who received three or more single-donor platelet concentrates during a 1-year period. Flow-cytometric detection of anti-platelet antibodies and a glycoprotein-specific ELISA were applied for the diagnosis of alloimmunization. Forty patients (27.6%) had at least one episode of refractoriness. In 25 of these 40 patients (62.5%), nonimmune factors (fever, sepsis, coagulopathy, splenomegaly) alone were the cause. In 15 refractory patients alloantibodies were detected. In seven patients (17.5%), alloimmunization alone caused an inadequate transfusion response, while in eight refractory patients (20.0%) alloimmunization and fever or sepsis were present. HLA antibodies were detected in 17 patients (11.7%); three patients (2%) had platelet-specific antibodies in addition to HLA antibodies; in two patients panreactive platelet antibodies were detectable. All 17 patients had a history of previous transfusions or pregnancy. We did not observe primary immunization in patients transfused exclusively with filtered (leukodepleted) blood products. Our data suggest that alloimmunization in patients with a negative risk history can be prevented by the exclusive use of leukodepleted blood components. |
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Authors:
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T J Legler; I Fischer; J Dittmann; G Simson; R Lynen; A Humpe; J Riggert; E Schleyer; W Kern; W Hiddemann; M Köhler |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Annals of hematology Volume: 74 ISSN: 0939-5555 ISO Abbreviation: Ann. Hematol. Publication Date: 1997 Apr |
Date Detail:
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Created Date: 1997-06-18 Completed Date: 1997-06-18 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 9107334 Medline TA: Ann Hematol Country: GERMANY |
Other Details:
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Languages: eng Pagination: 185-9 Citation Subset: IM |
Affiliation:
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Department of Transfusion Medicine, University of Göttingen, Germany. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Antigens, Human Platelet
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immunology Female Flow Cytometry HLA Antigens / immunology Humans Immunoglobulin G / immunology Isoantibodies / analysis* Leukapheresis Male Platelet Transfusion* |
| Chemical | |
Reg. No./Substance:
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0/Antigens, Human Platelet; 0/HLA Antigens; 0/Immunoglobulin G; 0/Isoantibodies |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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