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Alloimmunization after granulocyte transfusions

D F Stroncek1, K Leonard, G Eiber

  • 1American Red Cross, North Central Blood Services, St. Paul, Minnesota, USA.

Transfusion
|November 1, 1996
PubMed
Summary
This summary is machine-generated.

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Granulocyte transfusions can lead to white cell (WBC) antibodies in recipients, causing transfusion reactions. Screening for these antibodies is crucial; if present, use compatible donors for future transfusions.

Area of Science:

  • Immunology
  • Transfusion Medicine
  • Hematology

Background:

  • Granulocyte transfusions are vital for neutropenic patients with refractory bacterial infections.
  • Recipient white cell (WBC) antibodies can significantly reduce transfusion efficacy.

Observation:

  • A retrospective study analyzed 18 patients with chronic granulomatous disease receiving repeated granulocyte transfusions.
  • One patient experienced a pulmonary transfusion reaction due to NA2 neutrophil antigen immunization.

Findings:

  • 14 of 18 patients developed WBC antibodies post-transfusion.
  • Antibodies against neutrophil antigens (NB1, CD11a, CD18) and HLA were detected in 8 patients.
  • Transfusion reactions, including pulmonary reactions, were significantly more common in patients with WBC antibodies.

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Implications:

  • Alloimmunization to WBC antigens is a frequent complication of granulocyte transfusions.
  • Periodic screening for WBC antibodies is recommended, especially after adverse reactions.
  • Utilizing HLA- and/or neutrophil antigen-compatible granulocytes is essential for patients with detected antibodies.