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Identification of platelet refractoriness in oncohematologic patients
OBJECTIVES: To identify the occurrence and the causes of platelet refractoriness in oncohematologic patients. INTRODUCTION: Platelet refractoriness (unsatisfactory post-transfusion platelet increment) is a severe problem that impairs the treatment of oncohematologic patients and is not routinely inv...
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Formato: | Texto |
Lenguaje: | English |
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Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
2011
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3044569/ https://www.ncbi.nlm.nih.gov/pubmed/21437433 http://dx.doi.org/10.1590/S1807-59322011000100007 |
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author | Ferreira, Aline Aparecida Zulli, Roberto Soares, Sheila de Castro, Vagner Moraes-Souza, Helio |
author_facet | Ferreira, Aline Aparecida Zulli, Roberto Soares, Sheila de Castro, Vagner Moraes-Souza, Helio |
author_sort | Ferreira, Aline Aparecida |
collection | PubMed |
description | OBJECTIVES: To identify the occurrence and the causes of platelet refractoriness in oncohematologic patients. INTRODUCTION: Platelet refractoriness (unsatisfactory post-transfusion platelet increment) is a severe problem that impairs the treatment of oncohematologic patients and is not routinely investigated in most Brazilian services. METHODS: Forty-four episodes of platelet concentrate transfusion were evaluated in 16 patients according to the following parameters: corrected count increment, clinical conditions and detection of anti-platelet antibodies by the platelet immunofluorescence test (PIFT) and panel reactive antibodies against human leukocyte antigen class I (PRA-HLA). RESULTS: Of the 16 patients evaluated (median age: 53 years), nine (56%) were women, seven of them with a history of pregnancy. An unsatisfactory increment was observed in 43% of the transfusion events, being more frequent in transfusions of random platelet concentrates (54%). Platelet refractoriness was confirmed in three patients (19%), who presented immunologic and non-immunologic causes. Alloantibodies were identified in eight patients (50%) by the PIFT and in three (19%) by the PRA-HLA. Among alloimmunized patients, nine (64%) had a history of transfusion, and three as a result of pregnancy (43%). Of the former, two were refractory (29%). No significant differences were observed, probably as a result of the small sample size. CONCLUSION: The high rate of unsatisfactory platelet increment, refractoriness and alloimmunization observed support the need to set up protocols for the investigation of this complication in all chronically transfused patients, a fundamental requirement for the guarantee of adequate management. |
format | Text |
id | pubmed-3044569 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo |
record_format | MEDLINE/PubMed |
spelling | pubmed-30445692011-02-24 Identification of platelet refractoriness in oncohematologic patients Ferreira, Aline Aparecida Zulli, Roberto Soares, Sheila de Castro, Vagner Moraes-Souza, Helio Clinics (Sao Paulo) Clinical Science OBJECTIVES: To identify the occurrence and the causes of platelet refractoriness in oncohematologic patients. INTRODUCTION: Platelet refractoriness (unsatisfactory post-transfusion platelet increment) is a severe problem that impairs the treatment of oncohematologic patients and is not routinely investigated in most Brazilian services. METHODS: Forty-four episodes of platelet concentrate transfusion were evaluated in 16 patients according to the following parameters: corrected count increment, clinical conditions and detection of anti-platelet antibodies by the platelet immunofluorescence test (PIFT) and panel reactive antibodies against human leukocyte antigen class I (PRA-HLA). RESULTS: Of the 16 patients evaluated (median age: 53 years), nine (56%) were women, seven of them with a history of pregnancy. An unsatisfactory increment was observed in 43% of the transfusion events, being more frequent in transfusions of random platelet concentrates (54%). Platelet refractoriness was confirmed in three patients (19%), who presented immunologic and non-immunologic causes. Alloantibodies were identified in eight patients (50%) by the PIFT and in three (19%) by the PRA-HLA. Among alloimmunized patients, nine (64%) had a history of transfusion, and three as a result of pregnancy (43%). Of the former, two were refractory (29%). No significant differences were observed, probably as a result of the small sample size. CONCLUSION: The high rate of unsatisfactory platelet increment, refractoriness and alloimmunization observed support the need to set up protocols for the investigation of this complication in all chronically transfused patients, a fundamental requirement for the guarantee of adequate management. Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo 2011-01 /pmc/articles/PMC3044569/ /pubmed/21437433 http://dx.doi.org/10.1590/S1807-59322011000100007 Text en Copyright © 2011 Hospital das Clínicas da FMUSP http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Science Ferreira, Aline Aparecida Zulli, Roberto Soares, Sheila de Castro, Vagner Moraes-Souza, Helio Identification of platelet refractoriness in oncohematologic patients |
title | Identification of platelet refractoriness in oncohematologic patients |
title_full | Identification of platelet refractoriness in oncohematologic patients |
title_fullStr | Identification of platelet refractoriness in oncohematologic patients |
title_full_unstemmed | Identification of platelet refractoriness in oncohematologic patients |
title_short | Identification of platelet refractoriness in oncohematologic patients |
title_sort | identification of platelet refractoriness in oncohematologic patients |
topic | Clinical Science |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3044569/ https://www.ncbi.nlm.nih.gov/pubmed/21437433 http://dx.doi.org/10.1590/S1807-59322011000100007 |
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