REFRACTORINESS TO PLATELET TRANSFUSIONS F OR THROMBOCYTOPENIA OF CENTRAL ORIGIN

This study, conducted under the auspices of ANDEM, was aimed at determ ining the reasons for the inefficacy of platelet transfusions for thro mbocytopenia of central origin, and to establish recommendations for t herapy and prevention. It was based on a critical review of the litera ture. Three main causes of inefficacy were identified: an immunologica l conflict (mainly anti-HLA alloimmunization), clinical status, and th e quality of platelet preparations (especially storage time). Our reco mmendations depend on several factors, such as the degree of urgency, the cause of platelet refractoriness, clinical status and the availabi lity of platelet preparations. The mainstay of the recommendations is prevention, based on the quality of platelet preparations (as fresh as possible, in adequate number preferably obtained by apheresis and ABO compatible) and on the prevention of anti-HLA alloimmunization.