LEUKOCYTE DEPLETION OF RANDOM SINGLE-DONOR PLATELET TRANSFUSIONS DOESNOT PREVENT SECONDARY HUMAN-LEUKOCYTE ANTIGEN-ALLOIMMUNIZATION AND REFRACTORINESS - A RANDOMIZED PROSPECTIVE-STUDY

We studied the value of leukocyte depletion of platelet transfusions f or the prevention of secondary human leukocyte antigen (HLA)-alloimmun ization in patients with a high-risk of prior immunization induced by pregnancies. Seventy-five female patients with hematologic malignancie s (mostly acute leukemia) and a history of pregnancy were randomized t o receive either standard random single-donor platelet transfusions (m ean leukocytes, 430 x 10(6) per transfusion) or leukocyte-depleted ran dom single-donor platelet transfusions. Leukocyte depletion to less th an 5 x 10(6) leukocytes per platelet transfusion (mean leukocytes, 2 x 10(6) per transfusion) was achieved by filtration. Of the 62 evaluabl e patients, refractoriness to random donor platelets occurred in 41% ( 14 of 34) of the patients in the standard group and in 29% (8 of 28) o f the patients in the filtered group (P = .52); anti-HLA antibodies de veloped in 43% (9 of 21) of individuals in the standard group and 44% (11 of 25) of cases in the filtered group. The time toward refractorin ess and development of anti-HLA antibodies was similar for both groups . We conclude that leukocyte depletion of random single-donor platelet products to less than 5 x 10(6) per transfusion does not reduce the i ncidence of refractoriness to random donor platelet transfusions becau se of boostering of anti-HLA antibodies. (C) 1995 by The American Soci ety of Hematology.