Zhongguo shuxue zazhi (Oct 2022)
Detection of platelet antibody and evaluation of platelet transfusion efficacy in patients with hematologic disease
Abstract
Objective To investigate the factors influencing the production of platelet antibody and its effect on clinical platelet transfusion. Methods This is a single-center prospective observational study. The research subjects were patients with hematological diseases in West China Hospital of Sichuan University from October 1, 2018 to September 30, 2019, and their plasma were collected before platelet transfusion to detect platelet antibodies using solid-phase agglutination method. According to the results of platelet antibody screening, the patients were divided into platelet antibody positive group and negative group. The t test and nonparametric Mann-Whitney U test were used to compare the transfusion efficacy of two groups. Patients’ demographic and clinical information, including age, gender, diagnosis, the units of platelets and RBC transfused, were collected via HIS6.2.0 and whole process management system of blood in clinical (version 3.0) to analyze the influence of age, gender and the disease on the positive rate of platelet antibodies, as well as the profile of platelet antibodies in patients with different diseases, the correlation between the positive rate of platelet antibodies and the history of blood/platelets transfusion. In additional, the platelet transfusion process was observed on site. Results A total of 316 patients with hematologic diseases were included in this study, mainly with acute myeloid leukemia(188/316, 59.5%). All patients were transfused 1671 U platelet [1~17(5.3±3.1)U each person] and 1896 U RBC products [0~38(7.8±4.6)U each person] during the treatment. Out of the 316 patients, platelet antibodies were found in 85 (26.9%) of them. No significant differences in the positive rates of platelet antibody after transfusion were notice by genders or ages(P>0.05). The incidence of platelet antibody was related to diseases (P0.05) between two groups. The minimum PLT count(5×109/L vs 9×109/L, P0.05)between two groups. According to transfusion events on site, the incidence of acute adverse reactions to transfusion was 13% (169/1 291). Conclusions The positive rates of platelet antibodies in patients with hematologic diseases were relatively high. In addition, the efficacy of platelet transfusion in positive group were worse than that in the negative group. It is recommended that platelet antibody testing should be routinely performed before transfusion in hematologic disease patients to select crossmatch-compatible platelets in order to improve the effectiveness of platelet transfusion.
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