Limited value of in vitro techniques for the detection of leukocyte alloantibodies during granulocyte transfusion therapy.

A 23-year-old male patient undergoing first induction chemotherapy for acute myeloid leukaemia received granulocyte transfusions on 10 consecutive days. An average of 2.1 X 10(10) granulocytes was given per square metre body surface area per day. Transfusion reactions and absence of post-transfusion granulocyte increment after the fifth granulocyte transfusion suggested the presence of leukocyte antibodies. However, no antibodies were detectable at this time by the lymphocytotoxicity test, the indirect granulocyte immunofluorescence test, or the platelet suspension immunofluorescence test. In contrast to the clinical observation, the serological detection of leukocyte antibodies was only possible 1 day after the last granulocyte transfusion.