Treatment of Severe Thrombocytopenia in Alloimmunized, Transfusion-Refractory Patients

Abstract

A significant proportion of patients with hematologic malignancies who are exposed to multiple transfusions will develop alloantibodies to platelet human leukocyte antigens (HLA), resulting in poor responses to subsequent platelet transfusions. Transfusion of HLA-identical platelets is an effective method of platelet support in these patients, but perfectly HLA-matched platelets are often not available. In this paper, we review the recent literature on platelet transfusion support in alloimmunized individuals and illustrate alternative management strategies with cases from our own practice.

Human Leukocyte and Granulocyte Antigens and Antibodies: The HLA and HNA Systems

“…[41][42][43][44] However, the provision of HLA-matched platelets does not always improve platelet recovery and survival. Such patients are refractory to random donor platelets and must be given HLA-matched or "semi-matched" apheresis components.…”

Rapid decreasing of transfused platelet in a cancerous patient: Anti-platelet antibody

“…[3] Treatment might be the use of human leukocyte antigen (HLA) matched platelet transfusion. [4] The use of steroid for suppression of immunity is mentioned somewhere but not approved. In this case, the problem still existed despite using of HLA identical platelet transfusion.…”