[Analysis of HLA and HPA Antibody Specificity and Evaluation of HLA Antigen Immunogenicity in 90 Platelet Transfusion Refractory Patients in Changchun Region].

OBJECTIVE

To detect HLA and HPA antibodies in patients with platelet transfusion refractoriness (PTR) in Changchun region, analyze their specificity, identify the major antibodies responsible for transfusion failure, and evaluate the immunogenicity of HLA antigens, so as to provide a basis for the development of clinical transfusion strategies.

METHODS

Blood samples were collected from 90 patients with PTR from January and December 2024. HLA and HPA antibodies were detected using flow cytometry-microsphere method and ELISA. Statistical analysis was performed to evaluate the distribution of antibodies and their association with transfusion failure. PCR-SSP technology was used to analyze the genotypes of the HPA-1~6, 10, 15, 21 systems.

RESULTS

Among the 90 patients, 40(44.4%) tested positive for platelet-associated antibodies. In the antibody-positive samples, the positivity rate of HLA antibody was 77.5% (31/40), the positivity rate of HPA antibody was 35.0% (14/40), and the co-existence rate of both antibodies was 12.5% (5/40). The alleles with the highest frequencies at the HLA-A, B, and C loci were A*02:01, B*13:02 , and C*06:02 , with corresponding antibody positivity rates of 38.7%, 54.8%, and 22.6%, and relative immunogenicities of 0.110 1, 0.159 6, and 0.342 9, respectively. The relative immunogenicities of the low-frequency alleles A*24:03, B*15:10 , and C*17:01 were 89.500 5, 66.588 8, and 29.349 7, respectively. The HPA-3 and HPA-15 systems exhibited high polymorphism.

CONCLUSION

This study systematically analyzes the specificity distri- bution of HLA and HPA antibodies and the immunogenicity of HLA antigens in PTR patients in Changchun region. It finds that HLA antibodies play a dominant role in transfusion failure, and certain low-frequency HLA alleles have higher immunogenicity.