Platelet antibody and its clinical significance in childhood acute leukemia

Objective In order to know the rules and the clinical significances of platelet antibody production after platelet transfusion in children with acute leukemia(AL),we tested the platelet antibody in 56 patients with AL,and discussed the relationship between platelet antibody production and platelet transfusion refractoriness(PTR).Methods Totally 56 AL children from the Department of Hematology and Oncology of West China Second Hospital of Sichuan Universary were recruitted between April 2010 to October 2011,all of whom were divided into 3 groups according to the different times of platelet transfusion in treatment process:group Ⅰ,who didn't receive platelet transfusion group Ⅱ,who received platelet transfusion for the second time,and group Ⅲ,who received platelet transfusions more than 5 times. The blood samples were collected within 1 hour after the platelet transfusion. Ten healthy children from the outpatient department were included as the control group who had no blood transfusion history. We used platelet antibody test agent to test the platelet antibody and the PAKPLUS kit to test the HLA-1 and HPA antibodies. In the meantime,we observed the clinical improvements in the children with positive platelet antibodies.Results The incidences of platelet antibody production among the three groups were statistically different(χ2= 8.313,P0.05). In group Ⅱand Ⅲ,the platelet antibody positive children had higher rate of invalid transfusion, but the difference was not significant(χ2= 1.163,P0.05).The rate of invalid transfusion in group Ⅲ was higher than that in group Ⅱwith statistical differences(χ2= 10.469,P0.05).Conclusion With frenquency of platelet transfusion increasing, the positive rate of platelet antibody production in AL children is getting higher. But the children with positivity of platelet antibody don't necessarily have platelet transfusion refractoriness(PTR).