1. Refractoriness to platelet transfusion in acute myeloid leukemia correlated with the optical density of anti-platelet factor 4/heparin antibodies
- Author
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Takahisa Yamane, Mika Nakamae, Chikahiko Sakamoto, Masayuki Hino, Asao Hirose, Mizuki Aimoto, Hideo Koh, Yoshiki Terada, Yasunobu Takeoka, Kiyoyuki Hagihara, Yoshitaka Nakao, Kazumasa Shiomoto, Takahiko Nakane, Shigeki Miyata, Hirohisa Nakamae, and Yasuhiro Nakashima
- Subjects
medicine.drug_class ,Platelet Transfusion ,Platelet Factor 4 ,Antibodies ,Heparin-induced thrombocytopenia ,medicine ,Humans ,Platelet ,Aged ,business.industry ,Heparin ,Platelet Count ,Anticoagulant ,Myeloid leukemia ,Hematology ,medicine.disease ,Thrombocytopenia ,Leukemia ,Leukemia, Myeloid, Acute ,Platelet transfusion ,Immunology ,Female ,business ,Platelet factor 4 ,medicine.drug - Abstract
A small number of reports have described cases of heparin-induced thrombocytopenia complicating hematological disorders with impaired platelet production. We describe the case of a 66-year-old woman with acute myeloid leukemia who exhibited unexplained refractoriness to platelet transfusion, while receiving heparin flushes, and was found to have anti-platelet factor 4 (PF4)/heparin antibodies with high optical density (OD) values (>2 units) detected by an enzyme-linked immunosorbent assay. After cessation of heparin flushes, her refractoriness to platelet transfusion resolved. We retrospectively confirmed that the OD values for anti-PF4/heparin antibodies declined gradually; refractoriness to platelet transfusion resolved when the OD values fell below 1.0 units. Given the absence of any other evident explanation for this phenomenon, and the correlation between the OD values for anti-PF4/heparin antibodies and the efficacy of platelet transfusions, we conclude that the patient's refractoriness to platelet transfusion was most likely caused by anti-PF4/heparin antibodies that had platelet-activating properties.
- Published
- 2013