ABSTRACT
Inanotherstudyof26patientsundergoingtreatmentforacuteleukemiaorautograftingfor relapsedHodgkin'sdiseasewhowererandomlyassignedtoreceiveeitherABO-compatibleor ABO-incompatibleplatelets,plateletrefractorinesswassignificantlylowerinthegroup receivingABO-compatibleplatelets-notonlybecausepatientsdidnotincreasetheiranti-Aor anti-BisohemagglutinintitersbutalsotheABO-compatiblerecipientshadamuchlower incidenceoflymphocytotoxicandplatelet-specificalloantibodies(45).Nineofthe13patients (69%)whoweregivenABO-mismatchedplatelettransfusionsbecameplateletrefractory comparedwithonly1of13patients(8%)whoreceivedABO-compatibleplatelets;p<0.0014
Figure1Estimatedsurvivalcurvesofrefractorinessbynumberofplatelettransfusions.Ordinate: Probability(%)ofnotbecomingrefractory.Logrankstatistic=10.3(p=0.0014).MMG=mismatched ABOgroupplatelets;OG=ownABOgroupplatelets.(FromRef.45.)
(Fig.1).TherepeatedadministrationofABO-mismatchedplateletsproducedasignificantrise inanti-AlBtitersin7of13patients(54%)thatweregenerallycorrelatedwithpoorplatelet increments.Inaddition,5of13recipients(38%)oftheABO-mismatchedplateletsdeveloped lymphocytotoxicantibodies,and4of13(31%)developedplatelet-specificalloantibodies comparedwithonly1of13(8%)and1of13(8%),respectively,oftherecipientsof ABO-compatibleplatelets.TheclosetemporalassociationbetweenthedevelopmentofHLA andplatelet-specificalloantibodiesandrisesinanti-AlBtiterssuggeststhat,intheprocessof respondingtotheABO-incompatibleantigens,recognitionofotherantigenincompatibilities alsooccurred.DatafromthesetwostudiessuggeststhatprovisionofABO-compatibleplatelets maybeasimplemethodofreducingtheincidenceofalloimmuneplateletrefractoriness.
