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A quasi‐experimental study evaluating the efficacy of crossmatch‐matched platelet transfusions in hemato‐oncology patients with suspected alloimmune platelet refractoriness: A single‐centre experience

Year: 2026

Type: article

Abstract: BACKGROUND: Platelet transfusion is essential in managing thrombocytopenia in hemato-oncology patients. This study aimed to determine the prevalence of platelet refractoriness (PR) and to evaluate the efficacy of crossmatch-compatible single-donor platelet (SDP) transfusions in patients with suspected platelet refractoriness. MATERIALS AND METHODS: A two-year quasi-experimental study comprised adult and paediatric hemato-oncology patients with two consecutive low corrected count increment (CCI) responses (<7500/μL) following SDP transfusions. Refractory patients with non-immune causes were tried to be excluded as far as possible. Platelet crossmatching was performed using solid-phase red cell adherence (SPRCA) technology. One-hour post-transfusion CCI and percentage platelet recovery (PPR) were evaluated between crossmatch-compatible and incompatible transfusions. Statistical analyses included descriptive statistics as mean ± standard deviation (SD), median with interquartile range (IQR), or frequencies (%). Multivariate regression analysis was used to identify predictors of transfusion response. RESULTS: Among 272 SDP transfused patients, 142 (52.2%) were refractory and of them, 101 were eligible for platelet crossmatching. Of the 166 SDP transfusions, 63.4% were crossmatch incompatible. Crossmatch-compatible transfusions yielded significantly higher mean CCI (17 788 vs. 11 913, p = 0.001) and PPR (44.8% vs. 28.7%, p < 0.001). Crossmatching demonstrated high sensitivity (84.8%) and NPV (86.4%) for detecting inadequate responses. Multivariate analysis identified platelet compatibility and age as significant predictors of transfusion efficacy. CONCLUSION: Crossmatch-compatible platelet transfusions significantly improve post-transfusion CCI and PPR in alloimmunised hemato-oncology patients. Crossmatch compatibility and patient age were identified as two independent predictors of adequate early platelet transfusion response (1-h CCI, PPR and platelet increment).

Source: Transfusion Medicine

DOI: 10.1111/tme.70058