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Frequency of Platelet Crossmatch Positivity and Predictive Value for Poor Platelet Increment Among Paediatric Oncohaematology Patients in India

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Indian Journal of Hematology and Blood Transfusion Aims and scope Submit manuscript

Abstract

Immune platelet destruction is a significant cause for platelet refractoriness. The platelet crossmatch—a solid phase red cell adherence assay utilizes donor platelets and patient serum to assess compatibility and appears to be a feasible option in resource constrained settings. This study was done to evaluate the frequency of platelet crossmatch positivity among Paediatric Oncohaematology patients and also to assess whether a positive crossmatch is predictive of unsuccessful platelet transfusions in this group of patients. Paediatric Oncohaematology patients who received platelet transfusions between March 2013 and September 2013 were included in the study. The pre-transfusion patient sample and a segment from the transfused donor unit were used for performing the platelet crossmatch. A blood sample was collected one hour after the transfusion to assess post-transfusion platelet count. Corrected count increment (CCI) was calculated using the standard formula. CCI ≤ 7500/µL/m2/1011 was considered evidence of an unsuccessful transfusion. Seventy-three platelet crossmatches were performed for 69 patients, of which 30 patient samples (41%) showed crossmatch positivity. 25 (89.2%) of 28 unsuccessful transfusions showed crossmatch positivity, and 40 (88.9%) of 45 successful transfusions showed negative crossmatches (p = 0.03). Crossmatch positivity among transfusion dependent Paediatric Oncohaematology patients was as high as 42%, when ABO matched platelet units were allocated without further testing. Our results indicate that this test may be a reliable tool to select compatible platelet units and an effective intervention in the management of patients at risk of immune platelet refractoriness.

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Acknowledgements

This study was supported intramurally by a Grant from the Christian Medical College, Vellore, India

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Authors and Affiliations

  1. Department of Transfusion Medicine and Immunohaematology, Christian Medical College, Vellore, Tamil Nadu, 632004, India

    Simon Kingsley, Mary Purna Chacko, P. Amal & Daniel Dolly

  2. Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, 632004, India

    Grace Rebekah

  3. Department of Paediatrics, Christian Medical College, Vellore, Tamil Nadu, 632004, India

    G. Mathew Leni

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  1. Simon Kingsley
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  2. Mary Purna Chacko
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  3. P. Amal
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Correspondence to Mary Purna Chacko.

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All procedures performed in the study were in accordance with ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Kingsley, S., Chacko, M.P., Amal, P. et al. Frequency of Platelet Crossmatch Positivity and Predictive Value for Poor Platelet Increment Among Paediatric Oncohaematology Patients in India. Indian J Hematol Blood Transfus 36, 164–170 (2020). https://doi.org/10.1007/s12288-019-01193-8

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