Platelet compatibility and platelet antibodies detection: A step towards resolving dilemma in management of platelet refractoriness in oncology patients

Mangwana, Sadhana; Kacker, Atin; Simon, Nikhil

doi:10.4103/gjtm.gjtm_51_19

Cited by 6 publications

(10 citation statements)

References 14 publications

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“…This study reported that 5.3% of solid cancer patientshave RBC alloimmunization, within the reported ranges of <1% to 11% by previous studies withsimilar groups of subjects. 2,3 However, the reported rate of RBC alloimmunization in the other groups of multi-transfused patients varied, ranging from 1-2% and even much higher, up to 30% in thalassaemia patients. 1,7,10 The observable range can be attributed to many factors, including the demography of the patient's cohort, number of PC transfusion exposure, local transfusion policy and the type of disease and comorbidities.…”

Section: Resultsmentioning

confidence: 99%

“…The prevalence was reported to be higher than in the haematological malignancy. 2,3 In Malaysia, all regularly transfused patients, such as thalassaemia patients, are required for RBC phenotyping for ABO, Rhesus (Rh), Kidd, Duffy (Fy) and MNS antigen at diagnosis or before the first transfusion as a strategy for prevention of RBC alloimmunization. 4 Many factors are associated with RBC alloimmunization in repeated transfused patients involving the recipient and environmental factors.…”

Section: Introductionmentioning

confidence: 99%

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Associated Factors of Red Blood Cell Alloimmunization among Solid Cancer Patients in Teaching Hospital in Malaysia

Wanik

Hassan

Noor

et al. 2023

Bangladesh J Med Sci

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Background: Alloimmunization is a known complication following repeated red blood cell transfusions. However, the associated factors of RBC alloimmunization are different among blood recipient groups. This study aimed to determine the associated factors of red blood cell alloimmunization among solid cancer patients in Hospital USM. Material and Methods: This cross-sectional study involved 322 adult solid cancer patients screened for red cell alloantibodies in our centre from October 2016 until February 2019. The clinical and transfusion data were obtained from the patient’s medical record and laboratory information system (My Transfusi). The multiple logistic regression was used for analysis of potential associated factors of red blood cells alloimmunization, and p-value of less than 0.050 was considered statistically significant. Results: The patient’s mean age was 52.0 years old, with the majority were Malays (91.0%) and females (61.2%). The most common cancers were breast (32.3%) followed by gastrointestinal (16.8%) and head and neck (14.3%). The presence of metastases (adjusted OR=13.53, p=0.017), numbers of packed red cell transfusions (adjusted OR=1.12, p= 0.015), and blood group A (adjusted OR=7.45, p=0.003) were the associated factors of alloimmunization. Conclusions: Solid cancer patients with metastases, received a higher number of packed red cell transfusions, and blood group A were at higher risk for alloimmunization. Strategies to provide phenotype RBC should focus on this type of patient to prevent red blood cells alloimmunization in solid cancer patients. Bangladesh Journal of Medical Science Vol. 22 No. 02 April’23 Page : 379-384

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Associated Factors of Red Blood Cell Alloimmunization among Solid Cancer Patients in Teaching Hospital in Malaysia

Wanik

Hassan

Noor

et al. 2023

Bangladesh J Med Sci

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“… 23 , 28 There are surprisingly few reports describing the benefit obtained from using SPRCA assays to identify cross-matched compatible platelets. 1 , 13 , 22 , 29 …”

Section: Discussionmentioning

confidence: 99%

“…The response to compatible platelets seen in our study is also consistent with that in prior studies that demonstrated a significant improvement in CCI using the SPRCA method to crossmatch platelets. 22 , 29 - 33 …”

Section: Discussionmentioning

confidence: 99%

Evaluation of Human Leucocyte Antigen Mediated Platelet Transfusion Refractoriness and Platelet Crossmatching Assay in Patients with Hematologic Disorders

Neanaey¹,

Deghady²,

Nafea³

et al. 2022

Oman Med J

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Objectives: Platelet refractoriness complicates the platelet transfusion, which is essential for managing thrombocytopenia in patients with hematological disorders. It is associated with adverse clinical outcomes and increased health care costs. We conducted a prospective study to determine the effectiveness of cross-matched compatible platelets in a group of patients refractory to platelets from random donors and to evaluate human leukocyte antigen (HLA)-mediated refractoriness. Methods: This prospective study was conducted on 40 patients with different hematological disorders requiring platelet transfusions who were refractory to random platelets and presented to the hematology unit of Alexandria's main university hospitals between May 2020 and March 2021. They received 60 ABO-compatible platelet transfusions, either leuco-reduced or random donor platelets, stored for no more than 72 hours. A solid-phase red cell adherence technique (SPRCA) was used for platelet crossmatching. The corrected count increment (CCI) was used to monitor the effectiveness of each platelet transfusion with a cut-off value of 5 × 103/µL at 1 hour and 2.5 × 103/µL at 24 hours. Anti-HLA antibodies were assessed using the enzyme-linked immunosorbent assay technique. Results: Out of 60 cross matches, 47 (78.3%) were compatible, and 13 (21.7%) were incompatible. Among 47 compatible results, 30 (63.8%) showed adequate CCI and 17 (36.2%) showed inadequate CCI at 1-hour post-transfusion. Among the incompatible results, 3 (23.1%) had adequate CCI and 10 (76.9%) had inadequate CCI. Significant improvements were found in the mean CCI when comparing cross-matched compatible platelets and incompatible platelets at 1hour or 24 hours (p=0.009 and p < 0.001, respectively). From the 40 studied patients, HLA alloimmunization was present in 18 patients (45.0%) and absent in the remaining 22 patients (55.0%). In the absence of HLA alloimmunization, patients showed significantly better responses at 1 hour and 24 hours (p =0.001 and p =0.015, respectively). There was better sensitivity of platelet crossmatching with random donor platelet concentrates than single donor platelet concentrates. Conclusions: Platelet crossmatching using SPRCA and HLA screening are effective and rapid tools for better management of patients' refractory to platelet transfusions.

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“…13 In India, routine antibody screening is not done in clinical practice except in a few centers. 14 In patients who have hemolytic anemia due to alloimmunization, screening and antigen matching are recommended to prevent further complications. 15 There are instances of alloimmunization which have occurred in the immediate post-transplant period leading to hemolysis and complicating the management due to the increased transfusion requirement post-ASCT.…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Acute Hemolytic Anemia in a Patient with Newly Diagnosed Multiple Myeloma: Maintaining a Fine Balance between Occam's Razor and Hickam's Dictum

Ovett

Karunakaran

Kalaiyarasi

et al. 2022

Indian J Med Paediatr Oncol

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Anemia is a common feature in multiple myeloma and is multifactorial. A 52-year-old lady was admitted to our hospital with complaints of fatigue, exertional dyspnea, paresthesia, and a recent-onset confusion state. Fundus examination revealed features of hyperviscosity. The patient received 2 units of packed red blood cell transfusion (PRBC) before the present hospital admission. Laboratory investigations revealed severe anemia and thrombocytopenia. The M-protein was 5.8 g/dL. Bone marrow showed sheets of plasma cells. Immunofixation electrophoresis confirmed the presence of an IgAλ band. FISH was positive for IgH-FGFR3 fusion. The investigations confirmed multiple myeloma R-ISS stage III. The patient was immediately started on CyBorD chemotherapy regimen. The patient had indirect hyperbilirubinemia and symptomatic anemia. Initial testing of the patient's sample showed blood grouping discrepancy with DCT, ICT, and auto control positive. The symptomatic anemia persisted requiring PRC transfusions. Further antibody study revealed the presence of anti-Jka antibody—a warm IgG antibody and cold antibody. Subsequently, the patient received Jka antigen-negative B-positive compatible PRBC transfusions and the hemoglobin normalized. Our patient had transfusion-associated alloimmunization along with hyperviscosity. The timely recognition and early institution of plasmapheresis and myeloma-directed therapy along with transfusion of compatible Jka antigen-negative PRBC lead to rapid improvement.

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Platelet compatibility and platelet antibodies detection: A step towards resolving dilemma in management of platelet refractoriness in oncology patients

Cited by 6 publications

References 14 publications

Associated Factors of Red Blood Cell Alloimmunization among Solid Cancer Patients in Teaching Hospital in Malaysia

Associated Factors of Red Blood Cell Alloimmunization among Solid Cancer Patients in Teaching Hospital in Malaysia

Evaluation of Human Leucocyte Antigen Mediated Platelet Transfusion Refractoriness and Platelet Crossmatching Assay in Patients with Hematologic Disorders

A Rare Case of Acute Hemolytic Anemia in a Patient with Newly Diagnosed Multiple Myeloma: Maintaining a Fine Balance between Occam's Razor and Hickam's Dictum

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