Exploration of HLA-matched platelet units in HLA-immunized PTR: A retrospective study of patients with hematological disorders

Abstract

Immunized platelet transfusion refractoriness (IPTR) has a high incidence of death and complications. HLA-matched platelet unit can effectively treat HLA-immunized PTR. A cohort study was undertaken on nine patients with IPTR hematological disorders who underwent HLA-matched PLT units due to HLA immunization at the First Affiliated Hospital of Soochow University between April 2022 and April 2023. We calculated the 14-hour corrected count increments (14 h-CCI) to evaluate the effect of PLT transfusions. A 14 h- CCI > 5000 was considered to be a successful transfusion. A total of 113 PLT units were transfused to the nine patients with HLA-immunized PTR. Of the 113 PLT units, 50 were random, 34 were cross-matched, and 29 were HLA-matched. The median 14 h-CCI values were 1683 for random PLT units, 5246 for cross-matched PLT units, and 5643 for HLA-matched PLT units (P = 0.02). Moreover, 10, 25, and 43.8% of transfusions were successful for random, cross-matched, and HLA-matched PLT units with non-immune factors (P = 0.013). Regarding non-immune factors, we confirmed that random PLT units, infection, splenomegaly, and bleeding affected platelet transfusion increments (P < 0.05).