Therapeutic plasma exchange in alloimmune platelet refractoriness

Sheharyar Raza; Christopher J Patriquin; Karen Yee; Akash Gupta; Waseem Anani; Jacqueline Wong; Cynthia Ellison; Lani Lieberman; Jacob Pendergrast; Christine Cserti-Gazdewich

doi:10.1016/j.transci.2023.103782

Therapeutic plasma exchange in alloimmune platelet refractoriness

Transfus Apher Sci. 2023 Dec;62(6):103782. doi: 10.1016/j.transci.2023.103782. Epub 2023 Aug 3.

Authors

Affiliations

¹ Division of Hematology, University of Toronto, Canada.
² Division of Hematology, University of Toronto, Canada; Division of Malignant Hematology and Oncology, Princess Margaret Cancer Center, Canada.
³ Division of Hematology, University of Toronto, Canada; National Platelet Immunobiology Laboratory, Canadian Blood Services, Canada.
⁴ National Platelet Immunobiology Laboratory, Canadian Blood Services, Canada.
⁵ HLA Laboratory, University Health Network, Canada.
⁶ Division of Hematology, University of Toronto, Canada; Blood Transfusion Laboratory, University Health Network, Canada.
⁷ Division of Hematology, University of Toronto, Canada; Blood Transfusion Laboratory, University Health Network, Canada. Electronic address: [email protected].

PMID: 37550092
DOI: 10.1016/j.transci.2023.103782

Abstract

Patients with alloimmune platelet refractoriness can present complex clinical conundrums. Herein we describe a case of platelet refractoriness in the setting of combined HLA and HPA alloimmunization in a patient with acute myeloid leukemia and life-threatening bleeding. We discuss causative antibodies and compare prevailing therapeutic modalities. We highlight plasma exchange as a potentially feasible, repeatable, and personalized treatment option for patients with extensive platelet alloimmunization who require transfusion.

Keywords: Apheresis; HLA; HPA; PTP; Platelet refractoriness.

Publication types

Case Reports

MeSH terms

Antigens, Human Platelet*
Blood Platelets
Humans
Isoantibodies
Plasma Exchange
Platelet Transfusion / adverse effects
Thrombocytopenia* / etiology

Substances

Isoantibodies
Antigens, Human Platelet