High-dose intravenous gamma globulin in alloimmunized platelet transfusion recipients [letter]

Abstract Ten patients, with bone marrow failure or malignant disorders, became refractory to platelet transfusions using random, as well as partial or fully HLA-matched, single-donor platelets. To determine its effect on platelet refractoriness, intravenous gamma globulin (IV IgG) was administered at 400 or 800 mg/kg/d for five days, and postinfusion platelet responses were monitored. Platelet transfusion responses following intravenous gamma globulin (IV IgG) were graded as follows: Excellent, 48-hour posttransfusion count greater than 50,000/microL; good, 48-hour count greater than 20,000 but less than 50,000/microL; Fair, increased increment, 48-hour count less than 20,000; and failed, no increased increment. Six of ten patients (60%) had improved responses to selected single-donor platelets (two were excellent, three were good, and one was fair). The time to achieve a platelet transfusion count greater than 25,000/microL ranged from one to nine days of IgG therapy. One individual had sustained benefit (greater than 1 year); the remaining responses persisted for 6 to 8 weeks. These results suggest that IV IgG may be useful in the management of platelet refractoriness, especially in patients receiving single-donor platelets.

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A case of tooth extraction in a patient of aplastic anemia enabled by using high dose intravenous gamma-globulin in platelet-transfusion refractory status.

Japanese Journal of Oral & Maxillofacial Surgery ◽

10.5794/jjoms.39.1084 ◽

1993 ◽

Vol 39 (10) ◽

pp. 1084-1086

Author(s):

Hiroyuki WATANABE ◽

Toshiya MATSUZAKI ◽

Yuji NAGUMO ◽

Kenji ONO ◽

Takafumi SATOMI ◽

...

Keyword(s):

Aplastic Anemia ◽

Platelet Transfusion ◽

Tooth Extraction ◽

Gamma Globulin ◽

High Dose ◽

Refractory Status ◽

Intravenous Gamma Globulin

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High-dose intravenous gamma globulin in alloimmunized platelet transfusion recipients [letter]

Blood ◽

10.1182/blood.v65.3.776.bloodjournal653776 ◽

1985 ◽

Vol 65 (3) ◽

pp. 776-776

Author(s):

C Knupp ◽

JK Chamberlain ◽

SO Raab

Keyword(s):

Platelet Transfusion ◽

Gamma Globulin ◽

High Dose ◽

Intravenous Gamma Globulin

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High-dose intravenous gamma globulin improves responses to single-donor platelets in patients refractory to platelet transfusion

Blood ◽

10.1182/blood.v70.5.1433.bloodjournal7051433 ◽

1987 ◽

Vol 70 (5) ◽

pp. 1433-1436

Author(s):

ZR Zeigler ◽

RK Shadduck ◽

CS Rosenfeld ◽

KF Mangan ◽

A Winkelstein ◽

...

Keyword(s):

Bone Marrow ◽

Platelet Transfusion ◽

Gamma Globulin ◽

Bone Marrow Failure ◽

High Dose ◽

Single Donor ◽

Intravenous Gamma Globulin ◽

Platelet Transfusions

Ten patients, with bone marrow failure or malignant disorders, became refractory to platelet transfusions using random, as well as partial or fully HLA-matched, single-donor platelets. To determine its effect on platelet refractoriness, intravenous gamma globulin (IV IgG) was administered at 400 or 800 mg/kg/d for five days, and postinfusion platelet responses were monitored. Platelet transfusion responses following intravenous gamma globulin (IV IgG) were graded as follows: Excellent, 48-hour posttransfusion count greater than 50,000/microL; good, 48-hour count greater than 20,000 but less than 50,000/microL; Fair, increased increment, 48-hour count less than 20,000; and failed, no increased increment. Six of ten patients (60%) had improved responses to selected single-donor platelets (two were excellent, three were good, and one was fair). The time to achieve a platelet transfusion count greater than 25,000/microL ranged from one to nine days of IgG therapy. One individual had sustained benefit (greater than 1 year); the remaining responses persisted for 6 to 8 weeks. These results suggest that IV IgG may be useful in the management of platelet refractoriness, especially in patients receiving single-donor platelets.

Download Full-text