Pretransplant platelet transfusion refractoriness is not associated with platelet nonengraftment in T-replete hematopoietic progenitor cell transplantation for hematologic malignancies

Scott, Ashleigh, Baidya, Shoma, Butler, Jason, Morris, Kirk, Thornton, Alycia and Kennedy, Glen A. (2015) Pretransplant platelet transfusion refractoriness is not associated with platelet nonengraftment in T-replete hematopoietic progenitor cell transplantation for hematologic malignancies. Transfusion, 56 1: 164-169. doi:10.1111/trf.13263


Author Scott, Ashleigh
Baidya, Shoma
Butler, Jason
Morris, Kirk
Thornton, Alycia
Kennedy, Glen A.
Title Pretransplant platelet transfusion refractoriness is not associated with platelet nonengraftment in T-replete hematopoietic progenitor cell transplantation for hematologic malignancies
Journal name Transfusion   Check publisher's open access policy
ISSN 1537-2995
0041-1132
Publication date 2015-08-11
Sub-type Article (original research)
DOI 10.1111/trf.13263
Open Access Status Not yet assessed
Volume 56
Issue 1
Start page 164
End page 169
Total pages 6
Place of publication Hoboken, NJ, United States
Publisher Wiley-Blackwell Publishing
Collection year 2016
Language eng
Formatted abstract
Background:  Cellular engraftment after allogeneic hematopoietic progenitor cell transplantation (HPCT) can be affected by pre-HPCT antibodies against donor human leukocyte antigen (HLA; donor-specific antibodies [DSAs]), which are commonly acquired by either pregnancy or transfusion. Issues regarding high assay sensitivity and variable interpretation limit routine screening for DSAs. Platelet (PLT) transfusion refractoriness (PTR) is relatively common in patients with hematologic malignancies, and anti-HLA alloantibodies can be identified in up to 20% of cases. For patients with PTR undergoing subsequent allogeneic HPCT, however, the effect if any on subsequent PLT nonengraftment is unknown.

Study design and methods:  We conducted a retrospective study of 480 adults who underwent T-replete HPCT for hematologic malignancy and compared the posttransplantation clinical outcomes between patients who were PTR before HPCT and those who were not.

Results:  Multivariate analysis demonstrated that PTR was not directly associated with PLT nonengraftment or graft failure, but did predict for early intensive care unit admission, which was the only variable associated with these outcomes (p < 0.0001).

Conclusion:  Our findings suggest that PTR before HPCT identifies patients at higher risk of early clinical rather than immunologic complications.
Keyword Cellular engraftment
Allogeneichematopoietic progenitor cell transplantation (HPCT)
Pregnancy
Human leukocyte antigen
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Medicine Publications
 
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