The mean fluorescence intensities of anti-HLA antibodies detected using micro-bead flow cytometry predict the risk of platelet transfusion refractoriness

Ashanka Beligaswatte, Eleni Tsiopelas, Ian Humphreys, Greg Bennett, Kathryn Robinson, Ken Davis, Peter Bardy

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)

Abstract

There are no accepted methods to predict the development of platelet transfusion refractoriness (PTR) due to human leucocyte antigen (HLA)-alloimmunization. Hence, matched platelets are usually given only to patients demonstrating PTR, necessarily resulting in some ineffective random donor platelets (RDPLT) transfusions. To assess its utility in predicting PTR, we retrospectively tested samples from 387 patients receiving chemotherapy for acute leukaemia or autologous transplantation using a micro-bead flow cytometry assay. The average of the mean fluorescence intensities (avgMFI) of the class I beads in the screening assay was correlated with outcomes of RDPLT transfusions during a 2 week period. Antibodies were detected in 57 patients; 66 developed PTR, of whom 28 were alloimmunized. avgMFI usefully predicted the development of PTR (area under the receiver operating curve 0·87, 95% confidence interval: 0·77-0·96). A logistic regression model estimated the probability of PTR to be >90% when avgMFI >5440. These results indicate that micro-bead flow cytometry assays could inform a risk-adapted strategy for managing thrombocytopaenic HLA allo-immunized patients.

Original languageEnglish
Pages (from-to)409-412
Number of pages4
JournalBritish Journal of Haematology
Volume162
Issue number3
DOIs
Publication statusPublished - 1 Aug 2013
Externally publishedYes

Keywords

  • HLA antibodies
  • Micro-bead flow cytometry
  • Platelet transfusion refractoriness

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