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).
Kaur et al. (Thu,) studied this question.