Frequency and specificity of platelet‐specific alloantibodies in HLA‐immunized haematologic–oncologic patients

The frequency and specificity of platelet‐alloantibodies to human platelet antigens (HPA) ‐1, ‐3 and ‐5 was investigated in 59 multitransfused, HLA‐immunized patients. Using the MAIPA test (monoclonal antibody specific immobilization of platelet antigens) platelet alloantibodies could be demonstrated in 10 (17%) patients.  In one patient the antibody was present prior to any transfusions and probably induced by multiple previous pregnancies. This antibody was directed to HPA‐5b. The remaining nine antibodies were found in patients (n = 36) with HLA‐antibodies reacting with over 95% of unselected lymphocytes. In these patients the target antigens were HPA‐1b in six, HPA‐3a in one and both antigens in two patients.  Our findings demonstrate platelet alloimmunization induced by transfusions to be restricted to patients with high HLA‐immunization. 25% of these patients (9/36) show platelet‐specific antibodies, primarily HPA‐1b.

[1]  J. Chiaroni,et al.  Neonatal Thrombocytopenia in HLA‐DR, ‐DQ, ‐DP‐Typed Mother due to Rare Anti‐HPA‐1b (PLA2) (Zwb) Fetomaternal Immunization , 1994, Vox Sanguinis.

[2]  T. Lister,et al.  Relative Importance of Immune and Non‐Immune Causes of Platelet Refractoriness , 1994, Vox sanguinis.

[3]  A. Svejgaard,et al.  Post‐transfusion purpura: a survey of 12 Danish cases with special reference to immunoglobulin G subclasses of the platelet antibodies , 1994, Transfusion medicine.

[4]  H. Northoff,et al.  Serological Screening, Using Three Different Test Systems of Platelet‐Transfused Patients with Hematologic‐Oncologic Disorders , 1993, Vox sanguinis.

[5]  V. Kiefel,et al.  Posttransfusionelle Purpura: Klinische und immunologische Untersuchungen bei 38 Patientinnen , 1993 .

[6]  V. Kiefel.  The MAIPA assay and its applications in immunohaematology , 1992, Transfusion medicine.

[7]  A. Brand.  Sensitization by platelet transfusion. , 1991, Schweizerische medizinische Wochenschrift.

[8]  T. Kickler,et al.  Alloimmunization to platelet‐specific antigens on glycoproteins IIb‐ IIIa and Ib/IX in multiply transfused thrombocytopenic patients , 1990, Transfusion.

[9]  M. Murphy,et al.  Platelet transfusions: the problem of refractoriness. , 1990, Blood reviews.

[10]  G. Mueller‐Eckhardt,et al.  348 CASES OF SUSPECTED NEONATAL ALLOIMMUNE THROMBOCYTOPENIA , 1989, The Lancet.

[11]  C. Mueller-Eckhardt,et al.  Platelet transfusion refractoriness associated with two rare platelet‐ specific alloantibodies (anti‐Baka and anti‐PlA2) and multiple HLA antibodies , 1988, Transfusion.

[12]  F. Claas,et al.  Alloimmunization after Leukocyte‐Depleted Multiple Random Donor Platelet Transfusions , 1988, Vox sanguinis.

[13]  C. Mueller-Eckhardt,et al.  A New Platelet‐Specific Alloantigen Bra , 1988 .

[14]  V. Kiefel,et al.  Monoclonal antibody--specific immobilization of platelet antigens (MAIPA): a new tool for the identification of platelet-reactive antibodies. , 1987, Blood.

[15]  H. Braine,et al.  The predictive value of crossmatching platelet transfusion for alloimmunized patients , 1985, Transfusion.

[16]  A. E. G. Kr. vondem Borne,et al.  Serological studies in patients on platelet‐ and granulocyte‐substitution therapy , 1982, British journal of haematology.

[17]  Albert,et al.  Neonatal alloimmune thrombocytopenia: detection and characterization of the responsible antibodies by the platelet immunofluorescence test. , 1981, Blood.

[18]  K. Mittal.  Standardization of the HLA typing method and reagents. , 1978, Transplantation.