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Autoimmune-mediated thrombocytopenia after allogeneic hematopoietic stem cell transplantation: significance of detecting reticulated platelets and glycoprotein-specific platelet autoantibodies
- Source :
- International Journal of Hematology. 115:322-328
- Publication Year :
- 2022
- Publisher :
- Springer Science and Business Media LLC, 2022.
-
Abstract
- Autoimmune hematological disorders are rare complications after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Diagnosis of immune thrombocytopenia (ITP) is challenging, especially after allo-HSCT, because various complications such as graft-versus-host disease, disease relapse, viral infection, thrombotic microangiopathy, and drug side effects can also cause thrombocytopenia. Assessment of reticulated platelets (RP) and plasma thrombopoietin (TPO) levels may be useful to distinguish between ITP and hypoplastic thrombocytopenia. ITP is generally characterized by an increased percentage of RP, and a normal or slightly increased plasma TPO level. We now report three cases of thrombocytopenia after allo-HSCT. RP% was elevated in these patients, as it is in primary ITP. However, in contrast to primary ITP, plasma TPO levels were high in two of three patients. Anti-αIIbβ3 and anti-GPIb/IX-specific direct IgG antibodies were detected as well, suggesting occurrence of immune-mediated platelet destruction in addition to bone marrow suppression in two patients. All three patients were successfully treated with corticosteroids and/or thrombopoietin receptor agonists (TPO-RAs). These results suggest that increased RP% and detection of glycoprotein-specific platelet autoantibodies are useful for the diagnosis of ITP after HSCT.
- Subjects :
- Adult
Blood Platelets
Male
Purpura, Thrombocytopenic, Idiopathic
Adolescent
Platelet Count
Hematopoietic Stem Cell Transplantation
Platelet Membrane Glycoproteins
Hematology
Middle Aged
Postoperative Complications
Adrenal Cortex Hormones
Immunoglobulin G
Humans
Transplantation, Homologous
Female
Biomarkers
Autoantibodies
Subjects
Details
- ISSN :
- 18653774 and 09255710
- Volume :
- 115
- Database :
- OpenAIRE
- Journal :
- International Journal of Hematology
- Accession number :
- edsair.doi.dedup.....f48f65cef9273421c4c8f8787dbed2e6