Platelet transfusion refractoriness

Hod, Eldad A.; Schwartz, Joseph

doi:10.1111/j.1365-2141.2008.07189.x

Cited by 290 publications

(278 citation statements)

References 134 publications

(161 reference statements)

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“…2 Other non-Ab driven causes of refractoriness can include splenomegaly, sepsis, disseminated intravascular coagulation, venoocclusive disease, and graft-vshost disease. 2,37,38 Although many LCA 2 recipients were positive for HLA Abs using the newer assay, data collected using the 2 different assays matched well, with significantly higher levels of class I and class II HLA Abs detected among the LCA 1 recipients. All LCA 1 recipients tested positive for class I HLA Abs using the beadbased assay, although 30% were negative for class II Abs.…”

Section: Discussionmentioning

confidence: 79%

Low-level HLA antibodies do not predict platelet transfusion failure in TRAP study participants

Jackman

Deng

Bolgiano

et al. 2013

Blood

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• High, but not low to moderate, HLA antibody levels are associated with platelet refractoriness.In the Trial to Reduce Alloimmunization to Platelets (TRAP) study, 101 of 530 participants became refractory to platelet transfusions without evidence of HLA or human platelet antigen (HPA) antibodies. We used a more sensitive bead-based assay to detect and quantify HLA antibodies and a qualitative solid-phase enzyme-linked immunosorbet assay for HPA to determine whether low-level antibodies could predict refractoriness in longitudinal panels from 170 lymphocytotoxicity assay (LCA) 2 and 20 LCA Continuing Medical Education online This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Medscape, LLC and the American Society of Hematology. Medscape, LLC is accredited by the ACCME to provide continuing medical education for physicians. Medscape, LLC designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. All other clinicians completing this activity will be issued a certificate of participation. To participate in this journal CME activity: (1) review the learning objectives and author disclosures; (2) study the education content; (3) take the post-test with a 70% minimum passing score and complete the evaluation at http://www.medscape.org/journal/blood; and (4) view/print certificate. For CME questions, see page 3299. Disclosures The authors, Associate Editor Mortimer Poncz, and CME questions author Charles P. Vega, Associate Professor and Residency Director, Department of Family Medicine, University of California-Irvine, declare no competing financial interests. Learning objectives Upon completion of this activity, participants will be able to:1. Describe alloimmunization due to HLA after platelet transfusion. 2. Analyze the significance of human platelet antigen (HPA) antibodies (Abs) in cases of alloimmunization after transfusion. 3. Evaluate the performance of newer tests for HLA Ab and HPA Ab. 4. Assess the role of HLA Ab and HPA Ab among patients refractory to treatment with platelet transfusions.

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Section: Discussionmentioning

confidence: 79%

Low-level HLA antibodies do not predict platelet transfusion failure in TRAP study participants

Jackman

Deng

Bolgiano

et al. 2013

Blood

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“…Repeated platelet transfusion may, however, result in the development of an allergic reaction, as well as antibodies to human leukocyte antigen (HLA) or αIIbβ3 that may render future platelet transfusion ineffective. 2,[4][5][6] Previously, we showed that recombinant human factor VIIa (rFVIIa) was a good alternative therapeutic agent for bleeding and surgical prophylaxis in GT. 7,8 Data from a previous international survey of 59 patients treated for 108 bleeding episodes and 34 surgical/invasive procedures 7 allowed a preliminary suggestion for a more optimal rFVIIa regimen (rFVIIa ≥80 mg/kg given at ≤2.5-h intervals for three or more doses) for the treatment of moderate/severe bleeding episodes.…”

Section: Introductionmentioning

confidence: 99%

The international prospective Glanzmann Thrombasthenia Registry: treatment and outcomes in surgical intervention

d’Oiron

Zotz³

et al. 2015

Haematologica

118

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“…Repeated platelet transfusion may, however, result in the development of antibodies [to human leukocyte antigen (HLA) or to GPIIb/IIIa] which may render future platelet transfusions ineffective. 2,[12][13][14] Following the successful treatment of epistaxis in a GT patient, 15 several studies suggested that recombinant activated factor VII (rFVIIa; NovoSeven ® ) may be effective in the treatment of bleeding and the perioperative management of surgery in GT. [16][17][18] Notably, an international survey in GT patients treated for bleeds and surgical/invasive procedures showed good effectiveness and tolerability for rFVIIa given as bolus injections; the findings also allowed for a preliminary suggestion of an optimal dosing regimen (≥3 doses of ≥80 mg/kg given at intervals of ≤2.5 h) for the treatment of moderate-to-severe bleeding episodes.…”

Section: Introductionmentioning

confidence: 99%

The international prospective Glanzmann Thrombasthenia Registry: treatment modalities and outcomes in non-surgical bleeding episodes in Glanzmann thrombasthenia patients

Minno

Zotz²,

d’Oiron

et al. 2015

Haematologica

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© F e r r a t a S t o r t i F o u n d a t i o nMedicines Agency (EMA) for the treatment and prevention of bleeding episodes and in surgery or invasive procedures in GT patients with antibodies to GPIIb/IIIa and/or HLA, and a past or present history of platelet refractoriness to platelet transfusions. 20 To date, for GT patients who are not refractory, platelets are used as the first-line treatment.As part of the approval, the EMA required the collection of post-marketing pharmacovigilance data on rFVIIa in GT. The observational, international, multicenter, webbased Glanzmann's Thrombasthenia Registry (GTR) was, therefore, launched to prospectively gather and evaluate information on the different treatment modalities and their outcomes in "real-world" clinical practice. 21 Collection of such registry data is key to improving the understanding and management of rare diseases such as GT, for which randomized clinical trials are difficult to perform.This paper reports new, clinically relevant effectiveness and safety data on rFVIIa, as well as the other therapeutic options available (antifibrinolytics and platelets), for the treatment of non-surgical bleeds in patients with GT, using data obtained from the largest observational study of GT patients, the GTR. Methods PatientsFrom May 10, 2007, to December 16, 2011, prospectively collected online data were entered into the GTR on the effectiveness and safety (including thromboembolic events) of systemic hemostatic treatments used in clinics in patients with GT, including rFVIIa, platelet transfusions (P), and antifibrinolytics (AF) alone or in combination with other agents. All patients were treated according to local practices in an open-label manner, and no drugs were supplied for this registry. The main features of the GTR include: (i) standardized data collection using a customized webbased tool; (ii) a protocol-based registry conducted in accordance with general data protection laws and any local country requirements for conducting observational studies; and (iii) centralized data management overseen by an external expert panel composed of four physicians and by the international medical director of Novo Nordisk (the study sponsor). Protocol definitions and outcomes specified by the study sponsor, and post hoc classifications of bleed severity employed by the external expert panel (in response to requests by the EMA), are reported in Online Supplementary Table S1.Only patients with a diagnosis of congenital GT were included in the GTR (see Online Supplementary Table S1). Patients with acquired thrombasthenic states caused by autoimmune disorders or medications were excluded. Refractoriness and the presence of antibodies were coded initially and assessed periodically as deemed important by the investigator. As tests for antibodies may not have been available at all centers, antibodies may also have been present in some patients classified as having refractoriness only. Data handlingAs this was an observational study, treatment was based on local practice ...

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Platelet transfusion refractoriness

Cited by 290 publications

References 134 publications

Low-level HLA antibodies do not predict platelet transfusion failure in TRAP study participants

Low-level HLA antibodies do not predict platelet transfusion failure in TRAP study participants

The international prospective Glanzmann Thrombasthenia Registry: treatment and outcomes in surgical intervention

The international prospective Glanzmann Thrombasthenia Registry: treatment modalities and outcomes in non-surgical bleeding episodes in Glanzmann thrombasthenia patients

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