Beyond Refractoriness: Rare Antibody Investigations in Platelet and Neutrophil Immunology

Proposed Session Description: Immune-mediated thrombocytopenia and neutropenia can be some of the most challenging problems encountered in transfusion medicine and immunohematology laboratories. These cases often begin with unexplained cytopenias or poor response to transfusion support and require specialized testing to identify clinically significant antibodies.

This session will present complex investigations into platelet and neutrophil antibodies from two national reference laboratory programs. A transfusion medicine pathologist will review platelet serology and molecular cases, and a laboratory specialist will present challenging neutrophil antibody investigations.

Using real cases, the speakers will walk through the diagnostic process step by step, including testing algorithms, interpretation of serologic results, and the role of molecular methods in resolving difficult cases. Participants will see how uncommon antibodies are identified, how testing strategies evolve when results are inconclusive, and how these findings influence transfusion support.

The session will focus on practical laboratory decision-making: when to escalate testing, how to interpret complex or discordant results, and how reference laboratory findings translate into recommendations for blood product support. By comparing platelet and neutrophil investigations side by side, the session will highlight shared diagnostic principles and illustrate how specialized immunohematology testing supports patient care.