PMID- 33612449
OWN - NLM
STAT- MEDLINE
DCOM- 20211215
LR  - 20220207
IS  - 1473-0502 (Print)
IS  - 1473-0502 (Linking)
VI  - 60
IP  - 3
DP  - 2021 Jun
TI  - Practice patterns and clinical outcomes of platelet alloimmunization in a 
      comprehensive cancer center.
PG  - 103096
LID - S1473-0502(21)00051-3 [pii]
LID - 10.1016/j.transci.2021.103096 [doi]
AB  - BACKGROUND: Platelet transfusion refractoriness (PTR) secondary to human 
      leukocyte antigen (HLA) alloimmunization is a challenge in the treatment of 
      hematology-oncologypatients and increases the risk of morbidity and mortality 
      from bleeding events. Guidelines for treating PTR have not been clearly described 
      in literature. We aim to describe the practice patterns for the management of PTR 
      secondary to HLA alloimmunization, and to assess the mortality, thrombosis and 
      bleeding-related clinical outcomes at 30 days from diagnosis. METHODS: A 
      retrospective review of 51 cases of PTR secondary to HLA alloimmunization were 
      analyzed. RESULTS: The majority of patients (98 %) had a diagnosis of 
      hematological malignancy of which 88.2 % were undergoing active chemotherapy. 
      Clinically relevant bleeding, by ISTH criteria, was observed in 33.3 %; 
      hemorrhagic shock was diagnosed in 7%. The rate of bleeding-related mortality was 
      estimated at 7.8 %. The use of antifibrinolytics and plasma products (including 
      intravenous immunoglobulin) was more common in cases with major versus non-major 
      bleeding. Grade A or B1U HLA matched products were available in less than half of 
      cases. CONCLUSIONS: There is heterogeneity in the management of the bleeding risk 
      and bleeding events during PTR, with antifibrinolytics more commonly used in 
      patients who suffered severe bleeding. Grade A and B1U HLA-matched platelets are 
      not always readily available, and HLA-typing and HLA-antibody testing are not 
      always performed prior to PTR. Prospective randomized control trials may help to 
      determine the safety and efficacy of antifibrinolytics and other supportive 
      measures in the management of PTR.
CI  - Copyright (c) 2021 Elsevier Ltd. All rights reserved.
FAU - Goswamy, Rohit V
AU  - Goswamy RV
AD  - Department of Internal Medicine, The University of Texas Health Science Center at 
      Houston, Houston, TX, United States.
FAU - Wilson, Nathaniel R
AU  - Wilson NR
AD  - Department of Internal Medicine, The University of Texas Health Science Center at 
      Houston, Houston, TX, United States.
FAU - Tannenbaum, Daniel J
AU  - Tannenbaum DJ
AD  - Department of General Internal Medicine, The University of Texas MD Anderson 
      Cancer Center, Houston, TX, United States.
FAU - Aung, Fleur M
AU  - Aung FM
AD  - Department of Laboratory Medicine, Section of Transfusion Medicine, The 
      University of Texas M.D. Anderson Cancer Center, Houston, TX, United States.
FAU - Hernandez, Cristhiam Mauricio Rojas
AU  - Hernandez CMR
AD  - Section of Benign Hematology, The University of Texas MD Anderson Cancer Center, 
      Houston, TX, United States. Electronic address: CMRojas@mdanderson.org.
LA  - eng
PT  - Journal Article
DEP - 20210213
PL  - England
TA  - Transfus Apher Sci
JT  - Transfusion and apheresis science : official journal of the World Apheresis 
      Association : official journal of the European Society for Haemapheresis
JID - 101095653
RN  - 0 (Isoantibodies)
CIN - Transfus Apher Sci. 2021 Aug;60(4):103143. PMID: 34219019
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Blood Platelets/*immunology
MH  - Cancer Care Facilities
MH  - Female
MH  - Humans
MH  - Isoantibodies/*blood
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Young Adult
OTO - NOTNLM
OT  - Antifibrinolytics
OT  - Bleeding
OT  - HLA alloimmunization
OT  - Platelet transfusion refractoriness
OT  - Thrombopoietin mimetics
EDAT- 2021/02/23 06:00
MHDA- 2021/12/16 06:00
CRDT- 2021/02/22 05:49
PHST- 2020/11/27 00:00 [received]
PHST- 2021/02/05 00:00 [revised]
PHST- 2021/02/08 00:00 [accepted]
PHST- 2021/02/23 06:00 [pubmed]
PHST- 2021/12/16 06:00 [medline]
PHST- 2021/02/22 05:49 [entrez]
AID - S1473-0502(21)00051-3 [pii]
AID - 10.1016/j.transci.2021.103096 [doi]
PST - ppublish
SO  - Transfus Apher Sci. 2021 Jun;60(3):103096. doi: 10.1016/j.transci.2021.103096. 
      Epub 2021 Feb 13.