Abstract
A 14-year-old patient with acute nonlymphocytic leukemia became refractory to random platelets after frequent transfusions of multiple donor platelet concentrates. Lymphocyte toxic antibody was measured in the patient using NIH-LCT and the antiglobulin test for lymphocyte toxicity. A specific HLA-Bw4 antibody was demonstrated in her serum. PSIFT and β-thromboglobulin release test showed antibody against platelets from donors with HLA-Bw4 antigen. The patient had markedly poor post transfusion platelet recoveries following Bw4/Bw6 incompatible transfusion. In contrast, a mean 1 hour-post transfusion platelet recovery was at least 50% in 2 of 3 donors homozygous for Bw6. The clinical significance of Bw4 antibody is discussed.
