Platelet transfusion therapy. One-hour posttransfusion increments are valuable in predicting the need for HLA-matched preparations

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Abstract
Seventy-nine platelet transfusions to 73 thrombocytopenic patients with cancer were analyzed to determine whether a platelet count obtained 1 h after transfusion could help differentiate between alloimmunization and other clinical factors that result in rapid platelet destruction. These transfusions were selected because 18- to 24-h increments were inadequate in response to fresh, random donor platelets. A corrected count increment (CI) (CI = [posttransfusion count-pretransfusion count] .times. body surface area [m2]/platelets transfused .times. 1011) at 1 h of 10 .times. 103/.mu.l or greater was associated with absence of lymphocytotoxic antibody, whereas increments of < 10 .times. 103/.mu.l were generally associated with high levels of strongly cytotoxic antibody. HLA-matched transfusions produced no improvement in increments when the previous 1-h CI had been 10 .times. 103/.mu.l or greater, whereas in the other group significantly better increments were obtained. A 1-h posttransfusion count is a simple test that correlates well with the presence of antibody against HLA antigens, is valuable in predicting the need for HLA-matched platelets and helps avoid wasteful, empirical use of such transfusions.