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oai:figshare.com:article/33919432 2026-09-18T04:27:38Z category_393 portal_316 item_type_3 month_year_09_2026

Data Sheet 1_Personalized management of platelet transfusion refractoriness: risk factors, cross-matching, and IVIG strategies.pdf Jixin Li (5801207) Linting Wang (17125175) Yi Qin (115337) Yingyin Liang (11480963) Piao Lv (25069432) Yuan Yao (31223) Xinxin Fan (304701) Huayou Zhou (11774585) Foetal Development and Medicine alloimmunization corrected count increment (CCI) hematologic disorders intravenous immunoglobulin (IVIG) platelet antibodies platelet cross-matching platelet transfusion refractoriness risk factors Background<p>Platelet transfusion refractoriness (PTR) is a major clinical challenge in hematologic patients, yet real-world evidence comparing transfusion strategies—particularly the role of cross-matched platelets and intravenous immunoglobulin (IVIG)—remains limited.</p>Methods<p>We retrospectively analyzed 144 hematologic patients diagnosed with PTR at Nanfang Hospital (2019–2022), totalling 1,345 transfusion episodes. Patients were stratified by platelet antibody status. Four transfusion regimens were compared: random platelets, cross-matched platelets, random platelets + IVIG, and cross-matched platelets + IVIG. The primary endpoint was 24-h corrected count increment (CCI). Logistic regression identified factors associated with antibody development. The primary analysis was performed using linear mixed-effects models (LMMs) with a random intercept for patients to account for within-patient correlation. Fixed effects included transfusion strategy along with prespecified episode-level and patient-level covariates. Generalized estimating equations (GEE) were used as a sensitivity analysis to assess the robustness of the findings.</p>Results<p>Female sex emerged as the strongest independent predictor for the development of platelet antibodies (OR: 4.18, 95% CI: 2.25–8.24). Other univariate risk factors included age, obstetric history, diagnosis, and chemotherapy cycles. Among antibody-positive patients, both cross-matched platelets and IVIG combined with random platelets were associated with improved 24 h CCI compared with random platelets alone (all p_Holm < 0.001), cross-matched platelets were associated with higher 24 h CCI relative to random plus IVIG (p_Holm = 0.019), whereas cross-matched platelets plus IVIG demonstrated no additional benefit vs. cross-matched platelets alone in this cohort (p_Holm = 0.444). In antibody-negative patients, no statistically significant difference in 24 h CCI was observed across the four transfusion strategies (p = 0.244). Consistent with the LMM results, the overall effect of transfusion strategy was not statistically significant among antibody-negative patients (p = 0.692) but was significant among antibody-positive patients (p < 0.001). Similar results were obtained using GEE, supporting the robustness of these findings.</p>Conclusion<p>Among patients with antibody-negative PTR, cross-matched platelets and IVIG demonstrated no additional benefit in this cohort. For antibody-positive PTR, cross-matched platelets showed the most favorable response in this cohort; when unavailable, high-dose IVIG with random platelets may be preferentially considered. These comparative treatment findings require prospective validation.</p> 2026-09-18T04:27:38Z Dataset Dataset 10.3389/fmed.2026.1923303.s001 https://figshare.com/articles/dataset/Data_Sheet_1_Personalized_management_of_platelet_transfusion_refractoriness_risk_factors_cross-matching_and_IVIG_strategies_pdf/33919432 CC BY 4.0