Asian Journal of Transfusion Science
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LETTER TO THE EDITOR Table of Contents   
Year : 2012  |  Volume : 6  |  Issue : 2  |  Page : 192-193
Rapid decreasing of transfused platelet in a cancerous patient: Anti-platelet antibody


1 Sanitation 1 Road Medical Academic Center, Bangkok, Thailand
2 Wiwanitkit House, Bangkhae, Bangkok, Thailand

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Date of Web Publication24-Jul-2012
 

How to cite this article:
Joob B, Wiwanitkit V. Rapid decreasing of transfused platelet in a cancerous patient: Anti-platelet antibody. Asian J Transfus Sci 2012;6:192-3

How to cite this URL:
Joob B, Wiwanitkit V. Rapid decreasing of transfused platelet in a cancerous patient: Anti-platelet antibody. Asian J Transfus Sci [serial online] 2012 [cited 2019 Nov 22];6:192-3. Available from: http://www.ajts.org/text.asp?2012/6/2/192/98956


Sir,

The problem of thrombocytopenia is an important problem in cancerous patients undergoing cancer therapy. Here, the authors discuss a case study on platelet transfusion and anti-platelet antibody. The case was a female patient with colon cancer undertaking oral chemotherapy, capecitabine for many months. At first, the oncologist in charge observed thrombocytopenia (estimated platelet count about 30 000); hence, the platelet transfusion was given to this patient. However, after a short period (about 1.5 week) of the first transfusion, a decreased platelet count was observed; hence, repeated platelet transfusion was done. The repeated cycle of low platelet count, then platelet transfusion, then corrected low platelet count, and end up with repeated low platelet count occurred for 5 cycles (5 rounds of platelet transfusion, platelet concentration 1 U each round). A shorter period, more rapid decreasing of transfused platelet was observed (in the fifth round, the decrease occurred within 3 days). This case was consulted for finding of the possible cause of rapid decreasing of transfused platelet. In this case, the investigation was done and the was done and the positive finding was presence of anti-platelet antibody. Indeed, positive antiplatelet antibody can be seen in the cases with repeated platelet transfusion and it is relating to the shorter maintenance of transfused platelet or refractoriness in blood stream of the patient. In oncology patient, Baipai et al. reported that "response to transfusion therapy was poor in patients with antibodies, as 71.4% of patients with antibodies." [1] This condition is not uncommon but is usually forgotten by the physicians. The use of filtration and ultraviolet B irradiation might be useful but not highly effective in prevention of autoimmune induction in platelet transfusion. [2] Indeed, repeated platelet transfusion without finding of the exact etiology and correction should not be done. [3] Treatment might be the use of human leukocyte antigen (HLA) matched platelet transfusion. [4] The use of steroid for suppression of immunity is mentioned somewhere but not approved. In this case, the problem still existed despite using of HLA identical platelet transfusion. In this patient, further investigation was also done to find out the exact cause of thrombocytopenia in this case and it was finalized to be the case of heparin-induced thrombocytopenia.

 
   References Top

1.Bajpai M, Kaura B, Marwaha N, Kumari S, Sharma RR, Agnihotri SK. Platelet alloimmunization in multitransfused patients with haemato-oncological disorders. Natl Med J India 2005;18:134-6.  Back to cited text no. 1
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2.Leukocyte reduction and ultraviolet B irradiation of platelets to prevent alloimmunization and refractoriness to platelet transfusions. The Trial to Reduce Alloimmunization to Platelets Study Group. N Engl J Med 1997;337:1861-9.  Back to cited text no. 2
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3.Zimring JC, Welniak L, Semple JW, Ness PM, Slichter SJ, Spitalnik SL; NHLBI Alloimmunization Working Group. Current problems and future directions of transfusion-induced alloimmunization: Summary of an NHLBI working group. Transfusion 2011;51:435-41.   Back to cited text no. 3
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4.Ornstein DL, Mortara KL, Smith MB, Ririe DW, Shaughnessy PJ, Bickford DJ, et al. Treatment of severe thrombocytopenia in alloimmunized, transfusion-refractory patients. Mil Med 2001;166:269-74.  Back to cited text no. 4
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Correspondence Address:
Beuy Joob
Sanitation 1 Road Medical Academic Center, Bangkok
Thailand
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-6247.98956

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2006 - Asian Journal of Transfusion Science | Published by Wolters Kluwer - Medknow
Online since 10th November, 2006