Crossmatch-compatible platelets and HLA-matched platelets are commonly used in management of platelet refractory patients with immune causes like anti-HLA antibodies. The two type of platelets utilized by clinicians differ in practice because of region as well as objective factors such as not establishing HLA genotypic identity. We report our experience in a pediatric neuroblastoma-associated thrombocytopenia patient with anti-HLA antibodies who received 7 random-donor platelets (random PLTs) and 7 crossmatch-compatible platelets (compatible PLTs). Exploration of compatible PLTs transfusion effect and the causes affecting the occurrence of Platelet transfusion refractoriness (PTR) to provide evidence for management of pediatric patient with anti-HLA antibodies