Seike, Keisuke

English

Okayama University Digital Information Repository

造血幹細胞移植におけるバーチャルクロスマッチ適合血小板輸血の有効性についての検討

Okayama University Scientific Achievement Repository

Abstract 1 BACKGROUND: Cross-matched platelet (cross-matched PLT) transfusion is effective 2 for immune-mediated platelet transfusion refractoriness (PTR), but is more costly and 3 time-consuming for physical cross-match than using standard PLT units. Recent studies 4 have reported the utility of human leucocyte antigens (HLA) virtual cross-matched PLT 5 (HLA-matched PLT) that is defined as HLA-A/B matched or no antibody against 6 donor-specific antigen. Here, we evaluated the effect of HLA-matched PLT for PTR in 7 post hematopoietic stem cell transplant (HSCT) recipients. 8  9 STUDY DESIGN AND METHODS: Our study included a total of 241 PLTs in 16 10 patients who underwent HSCT at Okayama University Hospital between 2010 and 11 2017, receiving either HLA-matched or cross-matched PLT. We calculated the 24-hour 12 corrected count increments (CCI-24) to evaluate the effect of PLTs. A CCI-24 ≧4500 13 was considered to be a successful transfusion. 14  15 RESULTS: We analyzed 139 cross-matched PLTs and 102 HLA-matched PLTs. In the 16 immune-mediated PTR, the rate of successful transfusion was 60.5% for cross-matched 17 PLT and 63.4% for HLA-matched PLT (p = 0.825). On the other hand, the median CCI-18 24 for cross-matched PLT transfusions and HLA-matched PLT transfusions were 1856 19 and 5824 (p < 0.001), with a success rate of 28.1% and 54.1% in cases with non-20 immune-mediated PTR, respectively (p = 0.001). 21  22 CONCLUSION: The effectiveness of HLA-matched PLT is not inferior to cross-23 matched PLT. This result indicates that physical cross-match can be omitted in post 24 HSCT PTR. 25 

http://ousar.lib.okayama-u.ac.jp/files/public/6/60685/20200910095201608558/K0006227_summary.pdf

造血幹細胞移植におけるバーチャルクロスマッチ適合血小板輸血の有効性についての検討

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