International Journal of Hematology

, Volume 98, Issue 4, pp 472–477

Refractoriness to platelet transfusion in acute myeloid leukemia correlated with the optical density of anti-platelet factor 4/heparin antibodies

Authors

  • Mizuki Aimoto
    • Hematology, Graduate School of MedicineOsaka City University
    • Hematology, Graduate School of MedicineOsaka City University
  • Kazumasa Shiomoto
    • Central Clinical LaboratoryOsaka City University Medical School Hospital
  • Chikahiko Sakamoto
    • Hematology, Graduate School of MedicineOsaka City University
  • Yasuhiro Nakashima
    • Hematology, Graduate School of MedicineOsaka City University
  • Hideo Koh
    • Hematology, Graduate School of MedicineOsaka City University
  • Takahiko Nakane
    • Hematology, Graduate School of MedicineOsaka City University
  • Yasunobu Takeoka
    • Hematology, Graduate School of MedicineOsaka City University
  • Asao Hirose
    • Hematology, Graduate School of MedicineOsaka City University
  • Mika Nakamae
    • Hematology, Graduate School of MedicineOsaka City University
  • Kiyoyuki Hagihara
    • Hematology, Graduate School of MedicineOsaka City University
  • Yoshiki Terada
    • Hematology, Graduate School of MedicineOsaka City University
  • Yoshitaka Nakao
    • Hematology, Graduate School of MedicineOsaka City University
  • Hirohisa Nakamae
    • Hematology, Graduate School of MedicineOsaka City University
  • Masayuki Hino
    • Hematology, Graduate School of MedicineOsaka City University
  • Shigeki Miyata
    • Division of Transfusion MedicineNational Cerebral and Cardiovascular Centre
Case Report

DOI: 10.1007/s12185-013-1427-4

Cite this article as:
Aimoto, M., Yamane, T., Shiomoto, K. et al. Int J Hematol (2013) 98: 472. doi:10.1007/s12185-013-1427-4

Abstract

A small number of reports have described cases of heparin-induced thrombocytopenia complicating hematological disorders with impaired platelet production. We describe the case of a 66-year-old woman with acute myeloid leukemia who exhibited unexplained refractoriness to platelet transfusion, while receiving heparin flushes, and was found to have anti-platelet factor 4 (PF4)/heparin antibodies with high optical density (OD) values (>2 units) detected by an enzyme-linked immunosorbent assay. After cessation of heparin flushes, her refractoriness to platelet transfusion resolved. We retrospectively confirmed that the OD values for anti-PF4/heparin antibodies declined gradually; refractoriness to platelet transfusion resolved when the OD values fell below 1.0 units. Given the absence of any other evident explanation for this phenomenon, and the correlation between the OD values for anti-PF4/heparin antibodies and the efficacy of platelet transfusions, we conclude that the patient’s refractoriness to platelet transfusion was most likely caused by anti-PF4/heparin antibodies that had platelet-activating properties.

Keywords

Heparin-induced thrombocytopeniaRefractoriness to platelet transfusionAnti-platelet factor 4/heparin antibodies

Copyright information

© The Japanese Society of Hematology 2013