Premium
A comparison of prestorage WBC‐reduced whole‐blood‐derived platelets and bedside‐filtered whole‐blood‐derived platelets in autologous progenitor cell transplant
Author(s) -
Sweeney J.D.,
Kouttab N.M.,
Penn C.L.,
McHugh K.E.,
Nelson E.J.,
Oblon D.J.
Publication year - 2000
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1046/j.1537-2995.2000.40070794.x
Subject(s) - platelet , medicine , leukapheresis , whole blood , platelet transfusion , blood cell , progenitor cell , blood product , immunology , gastroenterology , surgery , andrology , stem cell , cd34 , biology , genetics
BACKGROUND : Prestorage WBC‐reduced platelet concentrates (PCs) can be manufactured from platelet‐rich plasma (PRP) by in‐line filtration of PRP. There are few published data on the clinical use of these products, as compared to bedside‐filtered pools of standard PCs (S‐PCs) manufactured from PRP. STUDY DESIGN AND METHODS : A prospective, randomized trial was conducted in autologous progenitor cell transplant patients requiring platelet transfusions with each patient as his or her own control who was given a pool of 5 units of WBC‐reduced PCs and a pool of 6 units of S‐PCs within a 3‐hour period. The pools were characterized before transfusion for platelet and WBC content, P‐selectin expression, and IL‐8. The patients were monitored with platelet counts and vital signs and observed for reactions. Data were analyzed using Mann‐Whitney U tests. RESULTS : Thirty‐three transfusions were administered to 13 patients. Median platelet content in the WBC‐reduced PC pools was lower than that in the S‐PC pools (3.3 vs. 4.0 × 10 11 , p<0.01). Median WBC content was 4 to 5 log less in the WBC‐reduced PC pools (2.5 × 10 4 vs. 4.6 × 10 8 , p<0.01). Median IL‐8 levels (pg/mL) were lower in the WBC‐reduced PC pools (2 vs. 36, p<0.01). No differences were observed in CCI, but the median absolute increase after transfusion of the S‐PC pools was higher (25 vs. 19 × 10 9 /L, p<0.01), which reflected the larger size of the S‐PC pools. No overall differences in vital signs were recorded. Two reactions were observed, both in temporal association with the transfusion of pools of S‐PCs. CONCLUSIONS : A pool consisting of 5 units of WBC‐reduced PCs gave a median platelet increment of 19 × 10 9 per L in these thrombocytopenic patients and has a median WBC content 1 to 2 log below the accepted threshold for primary alloimmunization or CMV transmission.