ABSTRACT Background: The selection of compatible human leukocyte antigen platelets has been associated with improved platelet increments. Therefore, an effective strategy would be the selection of donors who are genetically compatible according to the human leukocyte antigen system. Nonetheless, this is costly as it concerns a highly polymorphic system, which requires a large bank of genotyped donors. Methods: This study evaluated the feasibility of virtual crossmatching using EpVix software, which simplifies the identification of compatible donors or donors with acceptable incompatibilities. Results: Forty-three oncohematological patients were evaluated, in 96 platelet transfusion episodes with 16.3% of the patients being found to be refractory to platelet transfusions. Eight alloimmunized, multitransfused patients were selected to evaluate human leukocyte antigen compatibility against a bank of 336 platelet donors. At least partially compatible donors were found for all patients. The number of compatible donors was found to be inversely proportional to the human leukocyte antigen-panel reactive antibody score of each patient. It was noted that five patients with scores of 15% or less had at least 190 compatible donors; four fully compatible donors were found for two other patients with scores greater than 80% and only one patient (score of 93%) did not have a fully compatible donor. However, for this last patient, 40 donors were partially compatible according to the software. Conclusion: The results showed the effectiveness of the use of the EpVix tool to identify potential platelet donors for multitransfused and/or alloimmunized patients, even with a small number of human leukocyte antigen genotyped donors available.

O Stressful Life Events Schedule (SLES) é um instrumento que visa investigar a presença e o impacto de eventos de vida estressantes (EVE) ocorridos nos últimos 12 meses. O objetivo deste trabalho é traduzir e adaptar por equivalência semântica os itens da escala para a língua portuguesa. Seis etapas foram realizadas: (1) Tradução; (2) Retrotradução; (3) Revisão técnica e adaptação semântica; (4) Avaliação e validação do conteúdo e do significado geral considerando o contexto da população; (5) Realização de uma medida de confiabilidade em relação ao construto dependência/independência dos EVE; e (6) Produção da versão final do instrumento. O tempo verbal se manteve na maioria dos itens da escala. Algumas alterações foram necessárias como um acréscimo da variação de alguns termos. A versão adaptada demonstrou ser de fácil aplicação, não tendo sido avaliada como extensa e contemplando um número considerável de EVE.

The Stressful Life Events Schedule (SLES) is an instrument to investigate the presence and impact of stressful life events (SLE) occurred during the latest 12 months. The aim of this study is to translate and adapt, through semantic equivalence, the items from the instrument to the Portuguese language. The process had six steps: (1) Translation; (2) Backtranslation; (3) Technical review and semantic adaptation; (4) Assessment and content validation and overall meaning, considering the context of the population; (5) A measure of reliability was conducted in relation to the dependence/ independence construct; and (6) Production of the final version of the instrument. The verbal conjugation was maintained in most of the scale's items. Some changes were required, such as an addition of the variation of some terms. The adapted version proved to be of easy application, not too extensive and contemplating a considerable number of SLE.

El Stressful Life Events Schedule (SLES) es una escala que objetiva investigar la presencia y el impacto de los acontecimientos vitales estresantes (EVE) en los últimos 12 meses. El objetivo del presente estudio es traducir y adaptar por equivalencia semántica los ítems de la escala para la lengua portuguesa. Las seis etapas realizadas fueron: (1) traducción y (2) retraducción, (3) revisión técnica y adaptación semántica, (4) evaluación y validación del contenido y del significado general teniendo en cuenta el contexto de la población, (5) realización de una medida de fiabilidad para el constructo dependencia / independencia de los EVE, y (6) producción de la versión final del instrumento. El tiempo verbal se mantuvo en la mayoría de los ítems de la escala. Algunas modificaciones fueran necesarias, tales como el aumento de la variación de algunos términos. La versión adaptada se mostró de fácil aplicación, no evaluada como extensa y contemplando un número considerable de EVE.

OBJECTIVES: To identify the occurrence and the causes of platelet refractoriness in oncohematologic patients. INTRODUCTION: Platelet refractoriness (unsatisfactory post-transfusion platelet increment) is a severe problem that impairs the treatment of oncohematologic patients and is not routinely investigated in most Brazilian services. METHODS: Forty-four episodes of platelet concentrate transfusion were evaluated in 16 patients according to the following parameters: corrected count increment, clinical conditions and detection of anti-platelet antibodies by the platelet immunofluorescence test (PIFT) and panel reactive antibodies against human leukocyte antigen class I (PRA-HLA). RESULTS: Of the 16 patients evaluated (median age: 53 years), nine (56%) were women, seven of them with a history of pregnancy. An unsatisfactory increment was observed in 43% of the transfusion events, being more frequent in transfusions of random platelet concentrates (54%). Platelet refractoriness was confirmed in three patients (19%), who presented immunologic and non-immunologic causes. Alloantibodies were identified in eight patients (50%) by the PIFT and in three (19%) by the PRA-HLA. Among alloimmunized patients, nine (64%) had a history of transfusion, and three as a result of pregnancy (43%). Of the former, two were refractory (29%). No significant differences were observed, probably as a result of the small sample size. CONCLUSION: The high rate of unsatisfactory platelet increment, refractoriness and alloimmunization observed support the need to set up protocols for the investigation of this complication in all chronically transfused patients, a fundamental requirement for the guarantee of adequate management.