Global Journal of Transfusion Medicine (Jan 2016)
Evaluation of the platelet cross-matching in oncology patients
Abstract
Context: Platelet transfusion is an essential part of managing cancer. Refractoriness to platelet transfusion poses great challenge in the treatment of thrombocytopenic patients. Aims: The prospective study was undertaken to correlate and evaluate the result of the platelet cross-matching with posttransfusion count increment and to ascertain the effectiveness of routinely performing platelet cross-matching in Indian perspective. Subjects and Methods: ABO compatible, leukoreduced, random-donor platelets were randomly transfused to 30 thrombocytopenic, oncology patients. Platelet cross-match and platelet antibody screen were performed using solid-phase red-cell adherence (SPRCA) techniques and corrected count increment (CCI) was ascertained. Statistical Analysis: Statistical Package for Social Sciences version 16, Chi-square test were used for statistical analysis. Multivariate analysis and step-wise regression procedure were used to choose the set of best predictors. Results: One hundred and twenty-two units (86%) were negative cross-matched while 20 units (14%) were positive platelet cross-matched. Mean CCI was 28,927 ± 23,007 which was more and statistically significant in females than in males. Four cases (13.33%) showed platelet refractoriness with CCI <5000 including three cases of leukemia (25% of hematological malignancies). Patients with low CCI showed positive cross-match and antibodies against platelets. Conclusion: Platelet cross-match using SPRCA is an effective and rapid first-line approach for selecting compatible platelets as compared to human leucocyte antigen-matched platelets in the treatment of thrombocytopenic cancer patients. Platelet cross-match along with testing for anti-platelet antibodies should be an important component in the management of oncology patients which is less time-consuming and cost-effective than the molecular testing.
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