SUPPRESSION OF TRANSFUSION-RELATED ALLOIMMUNIZATION IN INTENSIVELY TREATED CANCER-PATIENTS

  • 1 January 1981
    • journal article
    • research article
    • Vol. 58  (1) , 122-128
Abstract
A retrospective review of HLA antibody testing and transfusion records of 100 cancer patients who required extensive platelet support revealed that 27 of 100 patients exhibited positive HLA antibody tests; only 13 remained positive on repetitive examination, while 88% of aplastic anemia patients so tested were positive. Sixty-five patients with leukemia, 16 with Ewing''s sarcoma and 19 with recurrent undifferentiated lymphoma were studied. Each patient received at least 10 U of platelets (mean of 72). HLA antibodies were detected in 31% (20/65) of the leukemias, 12% (2/16) of the Ewing''s and 26% (5/19) of the lymphoma patients. Of the 27 patients who developed antibodies, 14 became antibody negative again within 2 mo. and remained so. There were no significant differences in quantity of platelet transfusions between antibody-negative patients and alloimmunized patients. A smaller group (8) of aplastic anemia patients exhibited a frequency of alloimmunization of 88% (7/8) after a mean of 44 U of platelets were transfused. Granulocyte transfusions given therapeutically for granlocytopenia and documented infection did not appear to influence HLA antibody formation. Significant immunosuppression apparently occurs in intensively treated [chemotherapy] cancer patients, as measured by their ability to form antibodies to HLA antigens expressed on the surface of transfused platelets.