Re-evaluation of Modified Rapid Monoclonal Antibody Immobilization of Platelet Antigen (MR-MAIPA) For Detecting Platelet Antibody In Patients With Suspected Immune Thrombocytopenia

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Date
2016
Authors
Aziz, Mohd Fahmi
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Publisher
Universiti Sains Malaysia
Abstract
Introduction. Platelet antibody identification test in Malaysia is solely run by the National Blood Centre, Kuala Lumpur (NBCKL). Before 2013, the antibody identification test was using Monoclonal Antibody Immobilization of Platelet Antigen (MAIPA). However, MAIPA needs three days to complete the test. This may cause delay in detecting platelet reactive antibody, hence some inconveniences for clinician in treating their patients. Therefore, since July 2013, NBCKL had been utilizing MR-MAIPA for identifying platelet reactive antibody. Since MR-MAIPA implementation, no further re-evaluation of the method had been done. This study aims to evaluate MAIPA and MR-MAIPA in detecting the platelet antibody in NBCKL. Methods. A prospective study was conducted in which all samples sent to NBCKL from 1st June 2015 - 30th November 2015 for platelet antibody identification was included in the study. The sample is run both using MAIPA and MR-MAIPA concurrently. For MR-MAIPA, further evaluation was carried out, a titration of positive control (up to 1:256 dilution) was titrated to evaluate sensitivity of MR-MAIPA. All the data collected was analyze for specificity, sensitivity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV). Results. There were 40 samples from 40 different patients. Out of the 40 samples, 77.5% were negative for platelet reactive antibody and only 22.5% were positive for platelet reactive antibody, for both MR-MAIPA and MAIPA. The sensitivity, specificity, PPV and NPV of MR-MAIPA were comparable with MAIPA. For sensitivity, the MR-MAIPA was able to detect Anti-HPA 1a and Anti-HLA 1 up to dilution of 1:256. For Anti-HPA- 3a, MR-MAIPA was able to detect up to 1:8 dilution. Conclusions. The MR-MAIPA had equivalent sensitivity as MAIPA in detecting platelet reactive antibody. The MR-MAIPA has the advantage of completing the test within 5 hours to MAIPA that needs 8 hours to complete the test. The MR-MAIPA performance is suitable to be used for platelet antibody identification. However, the platelet panel used in both method need to be regularly monitored to ensure the test is precise in detecting platelet antibodies.
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Keywords
Modified Rapid Monoclonal Antibody , Immobilization of Platelet Antigen
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