The burden of immune‐mediated refractoriness to platelet transfusions in myelodysplastic syndromes

Autor: Anh Pham, Simon McRae, Erica M. Wood, Deepak Singhal, Li Yan A Wee, Rakchha Chhetri, Oisin Friel, Peter G Bardy, Devendra K Hiwase, David Roxby, Arabelle Salvi, Kathleen Pao Lynn Cheok
Rok vydání: 2020
Předmět:
Zdroj: Transfusion. 60:2192-2198
ISSN: 1537-2995
0041-1132
DOI: 10.1111/trf.16029
Popis: Up to 65% of patients with myelodysplastic syndromes (MDS) have thrombocytopenia and require platelet (PLT) transfusion. The current standard of practice is to provide random- or single-donor PLT transfusion and manage PLT refractoriness (PLT-R) if and when it develops. This study assessed the prevalence and risk factors for immune-mediated PLT-R in patients in the South Australian (SA) MDS Registry. Study design and methods A retrospective analysis of MDS patients enrolled in the SA-MDS registry was performed. HLA data was analyzed from January 2003 to 30 June 2017 to ensure minimum follow-up of 2 years. Results During the study period, 341 of 681 (50%) MDS patients required at least one PLT transfusion, with 29 of 341 (9%) of all PLT transfusion patients requiring HLA-matched PLT transfusion for PLT-R. Of these 29 patients, 70% were females treated with disease-modifying therapies suggesting that these patients are at high risk of HLA alloimmunization. Conclusions Immune-mediated PLT-R is common in MDS and can be expensive and difficult to manage once it occurs. Therefore, PLT transfusion practices should be optimized, especially for female MDS patients planned for disease-modifying therapies. This can help save time and streamline management, especially in the provision of PLT products for these patients, where the consequences of alloimmunization and PLT-R can be severe.
Databáze: OpenAIRE
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