Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Oct;60(10):2192-2198.
doi: 10.1111/trf.16029. Epub 2020 Sep 9.

The burden of immune-mediated refractoriness to platelet transfusions in myelodysplastic syndromes

Kathleen P L Cheok  1 , Rakchha Chhetri  1   2   3 , Li Yan A Wee  1   2 , Oisin Friel  1 , Anh Pham  4 , Arabelle Salvi  5 , Simon McRae  1 , Peter Bardy  1 , Deepak Singhal  1   2   6 , David J Roxby  7 , Erica M Wood  8   9 , Devendra K Hiwase  1   2   6
Affiliations

The burden of immune-mediated refractoriness to platelet transfusions in myelodysplastic syndromes

Kathleen P L Cheok et al. Transfusion. 2020 Oct.

Abstract

Up to 65% of patients with myelodysplastic syndromes (MDS) have thrombocytopenia and require platelet (PLT) transfusion. The current standard of practice is to provide random- or single-donor PLT transfusion and manage PLT refractoriness (PLT-R) if and when it develops. This study assessed the prevalence and risk factors for immune-mediated PLT-R in patients in the South Australian (SA) MDS Registry.

Study design and methods: A retrospective analysis of MDS patients enrolled in the SA-MDS registry was performed. HLA data was analyzed from January 2003 to 30 June 2017 to ensure minimum follow-up of 2 years.

Results: During the study period, 341 of 681 (50%) MDS patients required at least one PLT transfusion, with 29 of 341 (9%) of all PLT transfusion patients requiring HLA-matched PLT transfusion for PLT-R. Of these 29 patients, 70% were females treated with disease-modifying therapies suggesting that these patients are at high risk of HLA alloimmunization.

Conclusions: Immune-mediated PLT-R is common in MDS and can be expensive and difficult to manage once it occurs. Therefore, PLT transfusion practices should be optimized, especially for female MDS patients planned for disease-modifying therapies. This can help save time and streamline management, especially in the provision of PLT products for these patients, where the consequences of alloimmunization and PLT-R can be severe.

Keywords: myelodysplastic syndromes; platelet transfusions; thrombocytopenia.

PubMed Disclaimer

Comment in

References

REFERENCES

    1. Kantarjian H, Giles F, List A, et al. The incidence and impact of thrombocytopenia in myelodysplastic syndromes. Cancer. 2007;109:1705-1714.
    1. Neukirchen J, Blum S, Kuendgen A, et al. Platelet counts and haemorrhagic diathesis in patients with myelodysplastic syndromes. Eur J Haematol. 2009;83:477-482.
    1. Al Ameri A, Jabbour E, Garcia-Manero G, et al. Significance of thrombocytopenia in myelodysplastic syndromes: associations and prognostic implications. Clin Lymphoma Myeloma Leuk. 2011;11:237-241.
    1. Estcourt LJ, Birchall J, Allard S, et al. Guidelines for the use of platelet transfusions. Br J Haematol. 2017;176:365-394.
    1. Doughty HA, Murphy MF, Metcalfe P, Rohatiner AZS, Lister TA, Waters AH. Relative importance of immune and non-immune causes of platelet refractoriness. Vox Sang. 1994;66:200-205.

Publication types

Grants and funding