Minor impact of patient alloantibodies against human platelet antigen (HPA)-15 in the effectiveness of platelet transfusion: A pilot study
Minor impact of patient alloantibodies against human platelet antigen (HPA)-15 in the effectiveness of platelet transfusion: A pilot study
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DOI：
10.1111/trf.16181
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发表时间：
2020-11-09
期刊：
影响因子：
2.9
通讯作者：
Kuroishi, Ayumu
中科院分区：
文献类型：
--
作者：
Inoue, Hiroko;Sakamoto, Rumi;Kuroishi, Ayumu
研究设计与方法2例HPA-15同种异体抗体(患者1，抗HPA-15b；患者2，抗HPA-15a)和人类白细胞抗原(HLA)抗体阳性患者入选研究。根据血小板24小时校正计数增量(CCI-24小时)，比较HPA-15相合与血型不合的血小板输注的疗效。结果在监测期间，患者分别输注了71例和12例ABO血型相合、人类白细胞抗原相合的血小板。在这些输血中，分别有27次和10次可以计算出CCI-24小时，并确定了献血者的HPA-15基因。在两个患者中，HPA-15相合和不相容输血之间的CCI-24小时没有显著差异(分别为0.30和0.56，Mann-Whitney U检验)。患者1的HPA-15b抗体滴度在监测期间无明显变化，而患者2的HPA-15a抗体水平在监测结束时虽低，但在监测结束时仍未检测到。结论HPA-15血型不合的血小板输注的疗效不一定比HPA-15血型相合的效果差。虽然病例数量有限，但我们的结果表明，HPA-15抗体对血小板输注的效果没有显著影响。
Background Alloantibodies against human platelet antigen (HPA)-15 are sometimes detected in patients with platelet transfusion refractoriness (PTR); however, little is known about their impact on PTR.Study Design and Methods Two patients who possessed HPA-15 alloantibodies (Patient 1, anti-HPA-15b; Patient 2, anti-HPA-15a) and human leukocyte antigen (HLA) antibodies were enrolled. The efficacy of HPA-15-compatible vs -incompatible platelet transfusion was compared by focusing on ABO- and HLA-matched transfusions on the basis of the 24-hour corrected count increment (CCI-24 hours) for platelets. The titers of HPA-15 antibodies in the patients' sera were also monitored.Results The patients received 71 and 12 ABO-compatible, HLA-matched platelet transfusions, respectively, during the monitoring periods. Among these transfusions, CCI-24 hours could be calculated in 27 and 10 transfusions, respectively, and the HPA-15 genotype of the donors was determined. There were no significant differences in the CCI-24 hours between the HPA-15 compatible and incompatible transfusions in both patients (P = .30 and .56, respectively, Mann-Whitney U test). There was no significant change in the HPA-15b antibody titer in Patient 1 during the monitoring period, while the HPA-15a antibody level in Patient 2 was undetectable at the end of the monitoring period, although the titer was low at the beginning.Conclusion The efficacy of HPA-15-incompatible platelet transfusions was not necessarily inferior to that of HPA-15 compatible ones. Although the case number was limited, our results suggest that HPA-15 antibodies do not have a significant impact on the effects of platelet transfusion.