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The platelet dose (<jats:styled-content style=\"fixed-case\">PLADO<\/jats:styled-content>) trial, as the largest prospective randomized trial of prophylactic platelet therapy to date, afforded an opportunity to analyse these two issues.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">PLADO<\/jats:styled-content> patient records were examined for evidence of platelet alloimmunization, defined as an increase in <jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content> Class I panel\u2010reactive antibodies (<jats:styled-content style=\"fixed-case\">PRA<\/jats:styled-content>) to \u226520%, and clinical refractoriness, defined as two consecutive \u22644 h posttransfusion corrected platelet count increments (<jats:styled-content style=\"fixed-case\">CCI<\/jats:styled-content>) of &lt;5000. Multivariate logistic regression, restricted to platelet\u2010transfused subjects who received exclusively either in\u2010process leucoreduction apheresis or whole blood\u2010derived (<jats:styled-content style=\"fixed-case\">WBD<\/jats:styled-content>) leucocyte\u2010reduced platelets, compared the frequency of these outcomes by platelet unit and patient characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty of 816 evaluable platelet\u2010transfused patients (5%) became alloimmunized during the trial. Prior pregnancy, chemotherapy only compared to progenitor cell transplant, and low platelet dose \u2013 all were associated with significantly higher rates of alloimmunization. Among 35 alloimmunized patients evaluated for refractoriness, 8 (23%) had two consecutive <jats:styled-content style=\"fixed-case\">CCI<\/jats:styled-content> &lt; 5000\/\u03bcl. Regardless of alloimmunization status, <jats:styled-content style=\"fixed-case\">CCI<\/jats:styled-content>s &lt; 5000\/\u03bcl were observed following 17% of platelet transfusions. Among 734 patients receiving at least two platelet transfusions, two consecutive <jats:styled-content style=\"fixed-case\">CCI<\/jats:styled-content>s of \u22645000 occurred in 102 (14%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The incidence of new platelet alloimmunization was low in the <jats:styled-content style=\"fixed-case\">PLADO<\/jats:styled-content> study, but follow\u2010up was at most 30 days. Alloimmunization was present in only 8 of 102 (8%) of observed cases of refractoriness, suggesting that other causes of poor posttransfusion increments are frequent.<\/jats:p><\/jats:sec>","DOI":"10.1111\/vox.12411","type":"journal-article","created":{"date-parts":[[2016,5,17]],"date-time":"2016-05-17T11:17:31Z","timestamp":1463483851000},"page":"281-291","source":"Crossref","is-referenced-by-count":43,"title":["Clinical and laboratory correlates of platelet alloimmunization and refractoriness in the <scp>PLADO<\/scp> trial"],"prefix":"10.1111","volume":"111","author":[{"given":"J. R.","family":"Hess","sequence":"first","affiliation":[{"name":"University of Washington Seattle WA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F. L.","family":"Trachtenberg","sequence":"additional","affiliation":[{"name":"New England Research Institutes Watertown MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. F.","family":"Assmann","sequence":"additional","affiliation":[{"name":"New England Research Institutes Watertown MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D. J.","family":"Triulzi","sequence":"additional","affiliation":[{"name":"Institute for Transfusion Medicine University of Pittsburgh Pittsburgh PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. M.","family":"Kaufman","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. G.","family":"Strauss","sequence":"additional","affiliation":[{"name":"Institute for Transfusion Medicine University of Pittsburgh Pittsburgh PA USA"},{"name":"University of Iowa College of Medicine Iowa City IA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Granger","sequence":"additional","affiliation":[{"name":"New England Research Institutes Watertown MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. J.","family":"Slichter","sequence":"additional","affiliation":[{"name":"University of Washington Seattle WA USA"},{"name":"Bloodworks Northwest (formerly the Puget Sound Blood Center) Seattle WA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,5,17]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2008.01799.x"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-0039.2012.01852.x"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.4103\/0973-6247.137453"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.3109\/09537104.2014.895922"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199712253372601"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0904084"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1212772"},{"key":"e_1_2_8_9_1","doi-asserted-by":"crossref","first-page":"1727","DOI":"10.1182\/blood.V70.6.1727.1727","article-title":"Serial measurement of lymphocytotoxic antibody and response to nonmatched platelet transfusions in alloimmunized patients","volume":"70","author":"Lee EJ","year":"1987","journal-title":"Blood"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2003-12-4443"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2003-08-2724"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmrv.2010.11.002"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2006.00895.x"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0041-1132.2003.00607.x"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2011-11-393165"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.1999.39060586.x"}],"container-title":["Vox Sanguinis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fvox.12411","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/vox.12411","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,1]],"date-time":"2023-10-01T14:09:29Z","timestamp":1696169369000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/vox.12411"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,5,17]]},"references-count":15,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2016,10]]}},"alternative-id":["10.1111\/vox.12411"],"URL":"https:\/\/doi.org\/10.1111\/vox.12411","archive":["Portico"],"relation":{},"ISSN":["0042-9007","1423-0410"],"issn-type":[{"value":"0042-9007","type":"print"},{"value":"1423-0410","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,5,17]]}}}