Distribution for platelet antibody in patients with immune-mediated platelet transfusion refractoriness.

IF 1.6 4区医学 Q3 HEMATOLOGY

Hematology Pub Date : 2025-12-01 Epub Date: 2025-09-01 DOI:10.1080/16078454.2025.2549969

Bing Zhang, Kairong Ma, Xinyu Huang, Xiaozhen Hong, Ying Liu, Zhipan Wu, Xianguo Xu, Faming Zhu

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引用次数: 0

Abstract

Objectives: HLA Class I, HPA (Human platelet antigen), CD36 allo/isoantibodies, and platelet glycoprotein autoantibodies are the primary causes of immune-mediated platelet transfusion refractoriness (iPTR). Detecting these antibodies and selecting antigen-negative platelets for transfusion effectively manages iPTR, but large-scale data on platelet antibody distribution in the Chinese population are scarce.

Methods: From Jan 2021 to Dec 2023, 2073 patients with suspected iPTR underwent platelet cross-matching via solid-phase red blood cell adherence. Sera from those with positive cross-matching (≥1 donor) were analyzed for platelet antibodies using Luminex. Correlations between antibody prevalence, age, gender, and diseases were statistically analyzed.

Results: 621 patients, 30.0% (621/2073) had positive cross-matching with ≥1 donor. Furthermore, 374 (60.2%) patients had platelet antibodies. Moreover, 429 antibodies were detected in these patients, and the constituent ratios of HLA Class I alloantibodies, HPA alloantibodies, autoantibodies (GPIIb/IIIa, etc), and CD36 isoantibodies were 78.09%, 4.65%, 17.01%, and 0.23%, respectively. Abs ranked as follows: HLA Class I > GPIIb/IIIa > GPIa/IIa > HPA-5b, GPIb/IX > HPA-3a > HPA-1b, 2b > HPA-3b, 4b, CD36. Lastly, positive platelet antibodies prevalence correlated with age and sex in leukemia and solid tumor patient groups.

Discussion: This study clarified platelet antibody distribution in Chinese iPTR patients. Besides HLA Class I antibodies, autoantibodies against platelet glycoproteins play a key role. Among HPA antibodies, HPA-5b may predominate in the Chinese population instead of HPA-1a.

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免疫介导的血小板输注难治性患者血小板抗体的分布。

目的：HLA I类、HPA（人血小板抗原）、CD36等位基因/同种抗体和血小板糖蛋白自身抗体是免疫介导的血小板输血难耐（iPTR）的主要原因。检测这些抗体并选择抗原阴性的血小板输注可有效管理iPTR，但中国人群中血小板抗体分布的大规模数据很少。方法：2021年1月至2023年12月，2073例疑似iPTR患者通过固相红细胞粘附进行血小板交叉配型。交叉配型阳性（≥1个供体）的血清用Luminex进行血小板抗体分析。统计分析抗体流行率、年龄、性别和疾病之间的相关性。结果：621例患者，30.0%（621/2073）与≥1个供体交叉配型阳性。此外，374例（60.2%）患者有血小板抗体。检出抗体429种，HLA I类异体抗体、HPA异体抗体、自身抗体（GPIIb/IIIa等）和CD36同型抗体组成比分别为78.09%、4.65%、17.01%和0.23%。抗体排序如下：HLA I类> GPIIb/IIIa > gpiia /IIIa > HPA-5b、GPIb/IX > HPA-3a > HPA-1b、2b > HPA-3b、4b、CD36。最后，在白血病和实体瘤患者组中，血小板抗体阳性率与年龄和性别相关。讨论：本研究阐明了中国iPTR患者血小板抗体的分布。除了HLA I类抗体外，抗血小板糖蛋白的自身抗体也起着关键作用。在HPA抗体中，HPA-5b可能在中国人群中占主导地位，而不是HPA-1a。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hematology 医学-血液学

CiteScore

2.60

自引率

5.30%

发文量

140

审稿时长

3 months

期刊介绍： Hematology is an international journal publishing original and review articles in the field of general hematology, including oncology, pathology, biology, clinical research and epidemiology. Of the fixed sections, annotations are accepted on any general or scientific field: technical annotations covering current laboratory practice in general hematology, blood transfusion and clinical trials, and current clinical practice reviews the consensus driven areas of care and management.