Use of leucocyte‐poor blood components and HLA‐matched‐platelet donors to prevent HLA alloimmunization

Abstract

Summary. Recent studies have shown that the incidence of alloimmunization due to repeated platelet transfusions from random donors may be reduced by the use of leucocyte‐poor blood components. These results were confirmed by this study, where 16% of patients with acute leukaemia undergoing initial chemotherapy and receiving leucocyte‐poor blood components developed lymphocytotoxic antibodies, compared with 48% of patients in a control group receiving standard (non‐leucocyte‐depleted) blood components. In a third group, who received leucocyte‐poor blood components and HLA‐matched platelets, none of the patients developed lymphocytotoxic antibodies. There was a low incidence of platelet‐specific antibodies (8%) but no difference between the three groups. Improved methods of removing leucocytes from blood components appear to offer the best approach for minimizing HLA alloimmunization, as the provision of HLA‐matched platelet donors for prophylactic platelet support of all patients is not feasible.