A cost-effectiveness evaluation of platelet crossmatching and HLA matching in the management of alloimmunized thrombocytopenic patients

Transfusion
J FreedmanV Blanchette

Abstract

Effective platelet support for alloimmunized refractory thrombocytopenic patients may be provided by several potential strategies, the most common being HLA-matched single-donor platelets or crossmatch-compatible, pooled random- or single-donor platelets. This study used a detailed economic analysis to compare the cost-effectiveness of several techniques for platelet crossmatching and that of HLA-matched single-donor platelets. The crossmatch methods evaluated were a microlymphocytotoxicity test (LCT), an immunofluorescence technique (PSIFT), a radioactive antiglobulin test (PRAT), and an enzyme-linked immunosorbent assay (ELISA). The analysis was based on the need to support 100 refractory patients with acute leukemia with a presumed requirement of 500 transfusions. The relative costs for a successful crossmatch were: PRAT less than LCT less than LCT + PRAT less than PSIFT less than ELISA. In the comparison of the crossmatch methods, an increase in costs was generally associated with an increase in the number of successful transfusion episodes. However, decreasing marginal gains were seen. The HLA-matched single-donor platelets were relatively cost-inefficient in comparison to the crossmatch-compatible platelets. A theoretic s...Continue Reading

Citations

Oct 24, 2002·Current Opinion in Hematology·Paolo Rebulla
Jun 17, 2014·Blood Transfusion = Trasfusione Del Sangue·Osama S SalamaWesam E Elderiny
Oct 1, 1990·Transfusion Medicine Reviews·A E von dem BorneR W Kuijpers
Apr 5, 2013·Transfusion·Katerina PavenskiUNKNOWN International Collaboration for Guideline Development, Implementation and Evaluation for Transfusion Therapies (ICTMG) Colla
Sep 17, 2013·Transfusion·Ralph R VassalloUNKNOWN International Collaboration for Guideline Development, Implementation and Evaluation for Transfusion Therapies
Jul 22, 2015·British Journal of Haematology·Simon J StanworthJudith Marsh
Oct 1, 2015·Asian Journal of Transfusion Science·Serena ValsamiMarianna Politou
Jan 1, 1997·Journal of Clinical Apheresis·S J Slichter
Mar 7, 2001·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·C A SchifferUNKNOWN American Society of Clinical Oncology
Jan 1, 1995·Transfusion clinique et biologique : journal de la Société française de transfusion sanguine·G Andreu

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