rejecting platelets

[bebop]

My dad has been blood dependent for a year now and platelet dependent about 2 months. he went from getting normal plts to type and matched and now those aren't working either. Do any of you know how long he can go on like this? he got some on thursday and more today.

[gipper]

Hello Bebop,

How long he can go I don't know since it's such an individual thing. What I do know is that one will become refractory to platelet transfusions rather quickly. For example, I became refractory in about 25 platelet transfusions. Further, I've had a 100 rbc transfusions and others have had hundreds. So platelets are a distinctly different from reds. Initially you're transfused with pooled platelets or perhaps single donor platelets. Next you typically get type and matched platelets, which didn't work for me. After that they can give you HLA matched platelets, but these are very expensive. I was scheduled to have a splenectomy so my doctor ordered HLA matched platelets. However the hospital balked since the surgery could be canceled and they'd be on the hook for thousands of dollars. Smart move since my surgery was canceled the evening before it was to take place (my platelet count was too low at 23,000). Perhaps your father could be given Nplate or thalidomide. These drugs may increase his platelet count - Nplate did not do much more than stabilize my count since the dosage was kept quite low. However, I got a boost of 20,000 after only one month on thalidomide.

[bebop]

thank you for your reply. he is already getting the typed and matched plts but yesterday they had to give him the pooled. he became plts dependent really quick. he is growing so much weaker lately. I know no one knows the time though. only God knows that one. again thank you!