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Platelets photochemically treated with amotosalen HCl and ultraviolet A light correct prolonged bleeding times in patients with thrombocytopenia
Author(s) -
Slichter Sherrill J.,
Raife Thomas J.,
Davis Kathryn,
Rheinschmidt Margaret,
Buchholz Donald H.,
Corash Laurence,
Conlan Maureen G.
Publication year - 2006
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/j.1537-2995.2006.00791.x
Subject(s) - medicine , platelet , hemostasis , apheresis , plateletpheresis , platelet transfusion , anesthesia , blood transfusion , surgery , gastroenterology
BACKGROUND: Photochemical treatment (PCT) with amotosalen HCl with ultraviolet A illumination inactivates pathogens and white blood cells in platelet (PLT) concentrates. STUDY DESIGN AND METHODS: In a Phase II crossover study, 32 patients with thrombocytopenia received one transfusion of PCT and/or one transfusion of untreated (reference) apheresis PLTs. Hemostatic efficacy was assessed with the cutaneous template bleeding time and clinical observations. RESULTS: Paired bleeding time data for PCT and reference transfusions were available for 10 patients. Mean pretransfusion bleeding times were 29.2 ± 1.6 minutes in the PCT group and 28.7 ± 2.5 minutes in the reference group. After transfusion of a dose of PLTs of at least 6.0 × 10 11 , mean 1‐hour posttransfusion template bleeding times corrected to 19.3 ± 9.5 minutes in the PCT group and 14.3 ± 6.5 minutes in the reference group (p = 0.25). In 29 patients receiving paired PCT and reference transfusions, mean 1‐hour posttransfusion PLT count increments were 41.9 × 10 9 ± 20.8 × 10 9 and 52.3 × 10 9 ± 18.3 × 10 9 per L for PCT and reference, respectively (p = 0.007), and mean 1‐hour posttransfusion PLT corrected count increments (CCIs) were 10.4 × 10 3 ± 4.9 × 10 3 and 13.6 × 10 3 ± 4.3 × 10 3 for PCT and reference, respectively (p < 0.001). The time to next PLT transfusion was 2.9 ± 1.2 days after PCT transfusions versus 3.4 ± 1.3 days after reference transfusions (p = 0.18). Clinical hemostasis was not significantly different after PCT and reference transfusions. CONCLUSION: PCT PLTs provided correction of prolonged bleeding times and transfusion intervals not significantly different than reference PLTs despite significantly lower PLT count increments and CCIs.