Abstract:
BACKGROUND AND OBJECTIVES:Host- or donor-derived alloimmune thrombocytopenia can develop after non-myeloablative allogeneic haematopoietic stem cell transplantation (HSCT). We report the first case of host-derived HPA-1a antibodies. CASE REPORT:A 52-year-old male patient received HSCT from his human leucocyte antigen (HLA)-A, -B, -C, -DR identical brother after reduced intensity conditioning. Bilinear engraftment around day 12 was accompanied by a continuous decrease of platelet counts. We investigated for platelet antibodies because of a progressive decline of platelet counts and refractoriness to platelet transfusions. METHODS:The patient's serum was tested by enzyme-linked immunosorbent assay (ELISA), a solid phase assay and monoclonal antibody-specific immobilization of platelet antigens (MAIPA) assay. Recipient's DNA from the time before HSCT and donor's DNA were genotyped for human platelet antigens. RESULTS:Serum obtained on day 15 after HSCT reacted strongly with the donor's platelets due to host-derived anti-HPA-1a- and anti-HLA I antibodies. Serum samples from days 39, 45 and 65 after HSCT contained only anti-HLA I; no antibodies were detectable on day 149. Platelet counts increased on day 20 spontaneously. The decrease of the antibodies accompanied by the increase of the platelet counts suggests progressive elimination of residual host cells. CONCLUSIONS:The HPA-1a antibodies affected thrombopoietic engraftment and the success of platelet transfusions.
journal_name
Vox Sangjournal_title
Vox sanguinisauthors
Macher S,Schallmoser K,Staber PB,Neumeister P,Posch U,Lanzer G,Panzer Sdoi
10.1111/j.1423-0410.2005.00692.xsubject
Has Abstractpub_date
2005-11-01 00:00:00pages
257-60issue
4eissn
0042-9007issn
1423-0410pii
VOX692journal_volume
89pub_type
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