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Blood, 15 February 2006, Vol. 107, No. 4, pp. 1680-1687. Prepublished online as a Blood First Edition Paper on November 3, 2005; DOI 10.1182/blood-2004-10-4080. This Article Full Text (PDF) All Versions of this Article: 2004-10-4080v1 107/4/1680    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Nambiar, A. Articles by Marincola, F. Search for Related Content PubMed PubMed Citation Articles by Nambiar, A. Articles by Marincola, F. Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted November 1, 2004 Accepted February 18, 2005 HLAMatchmaker-driven analysis of responses to HLA-typed platelet transfusions in alloimmunized thrombocytopenic patients Ashok Nambiar, Rene Duquesnoy, Sharon Adams, Yingdong Zhao, Jaime Oblitas, Susan Leitman, David Stroncek, and Francesco Marincola* Department of Transfusion Medicine, National Institutes of Health, Bethesda, MD, USA Division of Transplantation Pathology, University of Pittsburgh, Pittsburgh, PA, USA Biometric Research Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA * Corresponding author; email: Fmarincola{at}mail.cc.nih.gov. This study describes a novel application of HLAMatchmaker to determine platelet compatibility in 16 alloimmunized patients with aplastic anemia refractory to random donor platelet transfusions. HLAMatchmaker is a software algorithm that predicts HLA compatibility by identifying immunogenic epitopes represented by amino acid triplets in antibody-accessible regions of human leukocyte antigen (HLA) molecules and determines the number of triplet mismatches (TMM) and highly immunogenic triplet mismatches (HIMM). Corrected count increments (CCIs) and molecular HLA typing were available for 523 transfusions. Conventional compatibility assessment based on cross-reactive group (CREG) determination was not predictive of transfusion outcome. Low HIMM and TMM number were associated with a higher likelihood of satisfactory (CCIs 8) compared with unsatisfactory (CCIs < 8) outcomes (median HIMM = 4 vs 6, p2-value < 0.001; median TMM = 11 vs 13, p2-value < 0.001). Although Receiver Operator Characteristic curves revealed that HIMM or TMM number are not powerful predictors of individual transfusion outcome, a threshold of 3 HIMM or 9 TMM appeared to be associated with successful transfusions. Triplet-matched transfusions were successful, regardless of CREG matching. Our data validate HLAMatchmaker for platelet transfusions and demonstrate its potential to refine and expand donor selection for HLA-alloimmunized patients. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

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