The role of alloantibodies against human platelet antigen-15 in multiply platelet transfused patients

• Published in: Transfusion (Philadelphia, Pa.) Pa.), 2014-04, Vol.54 (4), p.1093-1099
• Main Authors: Matsuhashi, Mika, Tsuno, Nelson H., Sone, Shinji, Mishima, Yuko, Nagura, Yutaka, Watanabe-Okochi, Naoko, Ikeda, Toshiyuki, Kashiwase, Koichi, Fukuda, Shinya, Iriyama, Takayuki, Hyodo, Hironobu, Yamashita, Takahiro, Kamei, Yoshimasa, Arai, Shunya, Minami, Mutsuhiko, Fujii, Tomoyuku, Kurokawa, Mineo, Tozuka, Minoru, Takahashi, Koki, Santoso, Sentot
• Format: Article
• Language: English
• Subjects: Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Antigens, CD - immunology; Antigens, Human Platelet - immunology; Asian Continental Ancestry Group; Biological and medical sciences; Blood platelets; Blood Platelets - immunology; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis; Cell Line; Cohort Studies; Female; GPI-Linked Proteins - immunology; Humans; Isoantibodies - immunology; Medical sciences; Neoplasm Proteins - immunology; Platelet Transfusion - adverse effects; Pregnancy; Pregnancy Complications, Hematologic - immunology; Recurrence; Thrombocytopenia - immunology; Transfusions. Complications. Transfusion reactions. Cell and gene therapy
• ISSN: 0041-1132; 1537-2995
• DOI: 10.1111/trf.12455

Background Several studies have documented the role of antibodies against human platelet (PLT) antigen (HPA)‐15 in alloimmune‐mediated thrombocytopenia including neonatal alloimmune thrombocytopenia, PLT transfusion refractoriness (PTR), and posttransfusion purpura in Caucasian persons. However, the relevance of anti‐HPA‐15 in PTR among the Japanese population is still unclear. Study Design and Methods The sera of 305 multiply PLT transfused (MPT) patients, previously investigated for the presence of human leukocyte antigen (HLA) and HPA antibodies by mixed passive hemagglutination, were reexamined for the presence of HPA‐15 alloantibodies, using the monoclonal antibody–specific immobilization of PLT antigens (MAIPA) technique. Results Among the 305 MPT samples, antibodies against HPA‐15 alloantigen was detected in seven (2.3%), two (0.66%) being anti‐HPA‐15a and five (1.64%) being anti‐HPA‐15b. Additionally, one case of CD109 panreactive antibody was found (0.33%). Among them, one aplastic anemia patient with blood group O developed multispecific anti‐HLA and anti‐HPA‐15b alloantibody after MPTs. However, transfusion with HLA‐matched PLTs of blood group AB did not result in adequate PLT count increment. Analysis of the possible influence of immune anti‐A and anti‐B by the MAIPA assay resulted negative, indicating that anti‐HPA‐15b is responsible for the refractory state in this patient. Conclusion In this study, we found alloimmunization against HPA‐15a and ‐15b in Japanese populations and demonstrated the relevance of these antibodies in a patient with PTR.