Long-Term Platelet Support of Patients with Aplastic Anemia

Long-term platelet transfusion support was studied in seven patients with aplastic anemia. All patients became refractory to platelets obtained from random donors by a median of 8 weeks. Once a patient became refractory, the poor response to random donor platelets was not improved by splenectomy, corticoids, or androgens, or any combination of these. Platelets from family donors matched for histocompatibility antigens were given twice weekly for periods up to 77 weeks and continually provided excellent clinical responses. Splenectomy or high-dose corticoid therapy, or both, improved the response to compatible platelets. The therapeutic benefit from compatible platelet infusion was substantially greater than could be provided by a fivefold greater mass of incompatible platelets.