Real‐time amplification of HLA‐DQA1 for counting residual white blood cells in filtered platelet concentrates

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Abstract
BACKGROUNDA real‐time polymerase chain reaction (PCR) assay based on amplification of a conserved region of the HLA‐DQA1 locus was developed and validated to assess its suitability in quantitating low levels of white blood cells (WBCs) in filtered platelet (PLT) concentrates (PCs).STUDY DESIGN AND METHODS: To determine the detection limit, serial dilutions of nonfiltered PCs with known quantities of WBCs were prepared. The analytical sensitivity and accuracy of the assay was tested with WBC concentrations ranging from 300 to 0.03 per µL with real‐time PCR and flow cytometry. In addition, 126 random PCs were investigated to assess the capacity of the PCR method to quantify residual WBCs in clinical specimens.RESULTS: A sensitivity of 0.2 WBC equivalent per µL (1.5 × 104WBC equivalents/unit) was achieved. The assay was shown to be accurate and the HLA‐DQA1 gene was reproducibly and consistently amplified in all tested samples (coefficient of variance of < 5%). Overall, the results of the PCR assay correlated well with those of the flow cytometry. The PCR assay detected a concentration of 3 WBCs per µL (approximately 1 × 106WBCs/unit) with 100 percent accuracy.CONCLUSION: Real‐time PCR is rapid, sensitive, accurate, and reproducible. Hence this approach may prove suitable in routine monitoring of residual WBCs in PCs.