Heparin-induced thrombocytopenia associated with collection of hematopoietic progenitor cells by apheresis

J Clin Apher. 2020 Jan;35(1):59-61. doi: 10.1002/jca.21757. Epub 2019 Nov 7.

Abstract

Heparin-induced thrombocytopenia (HIT) can occur following exposure to heparin and is characterized by thrombocytopenia with increased risk for thrombosis. This condition is mediated by formation of immunoglobulin G antibodies against platelet factor 4/heparin complexes that can subsequently lead to platelet activation. Herein, we detail the clinical and laboratory findings, treatments, and outcomes of two patients who developed HIT and thrombosis after undergoing collection of hematopoietic progenitor cells by apheresis (HPC-A) for autologous HPC transplant. Given that heparin may be used during HPC-A collections, these cases emphasize the importance of prompt consideration of HIT in patients that develop thrombocytopenia and thrombosis following HPC-A collection with heparin anticoagulation.

Keywords: HIT; apheresis; stem cell collection; thrombocytopenia; thrombosis.

MeSH terms

  • Aged
  • Albumins / chemistry
  • Antibodies / chemistry
  • Anticoagulants / adverse effects
  • Blood Component Removal / methods*
  • Electronic Health Records
  • Female
  • Hematopoietic Stem Cells / cytology*
  • Heparin / adverse effects*
  • Heparin / chemistry
  • Humans
  • Immunoglobulin G / immunology
  • Male
  • Middle Aged
  • Platelet Activation
  • Platelet Factor 4 / immunology
  • Retrospective Studies
  • Risk
  • Thrombocytopenia / chemically induced*
  • Thrombocytopenia / immunology
  • Thrombocytopenia / physiopathology*
  • Thrombosis / etiology

Substances

  • Albumins
  • Antibodies
  • Anticoagulants
  • Immunoglobulin G
  • PF4 protein, human
  • Platelet Factor 4
  • Heparin