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Post-Transplant Events

Efficacy of prophylactic transfusions using single donor apheresis platelets versus pooled platelet concentrates in AML/MDS patients receiving allogeneic hematopoietic stem cell transplantation

Abstract

Superiority of single-donor apheresis platelets (SDAP) over pooled platelet concentrates (PPC) transfusions is largely assumed, but unproven. We hypothesized that prophylactic SDAP and PPC transfusions are clinically equivalent after allogeneic hematopoietic stem cell transplants (HSCT). We studied all transfusions administered to 33 patients with AML/MDS during the first 100 days after busulfan-based, myeloablative HSCT. All donor–recipient pairs were ABO identical. Transfusion threshold was a platelet count 15 × 109/l. The corrected increment (CCI) was used for all comparisons. Median time to platelet engraftment was 13 days (n=30). PPC transfusions (n=105) were ABO compatible, while 10% of 41 SDAP were not (P=0.006). Median post-transfusion platelet count was 51K/μl (5–118K) after SDAP and 36K/μl (3–115K) after PPC (P=0.0004). Median CCI was 14.178 (SDAP) versus 7.793 (PPC) (P=0.0001). Median time to another transfusion was 3 days (SDAP) and 2 days (PPC; P=0.3). In the week following any given transfusion, the median number of new transfusions was similar (n=2), as well as the need of further transfusion (16 versus 24%, P=0.2). A total of 17% of SDAP and 30% of PPC transfusions were labeled ‘ineffective’ (P=0.1). There were two non-lethal hemorrhage episodes (6%). SDAP transfusions produced better platelet counts, but SDAP and PPC were equally effective in preventing hemorrhage.

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References

  1. Friedberg RC, Donnelly SF, Boyd JC, Gray LS, Mintz PD . Clinical and blood bank factors in the management of platelet refractoriness and alloimmunization. Blood 1993; 81: 3428–3434.

    CAS  PubMed  Google Scholar 

  2. Slichter SJ, Davis K, Enright H, Braine H, Gernsheimer T, Kao KJ et al. Factors affecting posttransfusion platelet increments, platelet refractoriness, and platelet transfusion intervals in thrombocytopenic patients. Blood 2005; 105: 4106–4114.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Schiffer CA . Diagnosis and management of refractoriness to platelet transfusion. Blood Rev 2001; 15: 175–180.

    Article  CAS  PubMed  Google Scholar 

  4. Kiefel V, Konig C, Kroll H, Santoso S . Platelet alloantibodies in transfused patients. Transfusion 2001; 41: 766–770.

    Article  CAS  PubMed  Google Scholar 

  5. Ishida A, Handa M, Wakui M, Okamoto S, Kamakura M, Ikeda Y . Clinical factors influencing posttransfusion platelet increment in patients undergoing hematopoietic progenitor cell transplantation – a prospective analysis. Transfusion 1998; 38: 839–847.

    Article  CAS  PubMed  Google Scholar 

  6. Bock M, Muggenthaler KH, Schmidt U, Heim MU . Influence of antibiotics on posttransfusion platelet increment. Transfusion 1996; 36: 952–954.

    Article  CAS  PubMed  Google Scholar 

  7. Toor AA, Choo SY, Little JA . Bleeding risk and platelet transfusion refractoriness in patients with acute myelogenous leukemia who undergo autologous stem cell. Bone Marrow Transplantat 2000; 26: 315–320.

    Article  CAS  Google Scholar 

  8. Nevo S, Swan V, Enger C, Wojno KJ, Bitton R, Shabooti M et al. Acute bleeding after bone marrow transplantation (BMT) – incidence and effect on survival. A quantitative analysis in 1402 patients. Blood 1998; 91: 1469–1477.

    CAS  Google Scholar 

  9. Seftel MD, Growe GH, Petraszko T, Benny WB, Le A, Lee CY et al. Universal prestorage leukoreduction in Canada decreases platelet alloimmunization and refractoriness. Blood 2004; 103: 33–339.

    Article  Google Scholar 

  10. The Trial to Reduce Alloimmunization to Platelets Study Group. Leukocyte reduction and ultraviolet B irradiation of platelets to prevent alloimmunization and ref-ractoriness to platelet transfusion. N Engl J Med 1997; 337: 1861–1869.

    Article  Google Scholar 

  11. Norol F, Bierling P, Roudot-Thoraval F, Le Couer FF, Rieux C, Lavaux A et al. Platelet transfusion: a dose–response study. Blood 1998; 4: 1448–1453.

    Google Scholar 

  12. Heal JM, Blumberg N . Optimizing platelet transfusion therapy. Blood Rev 2004; 18: 149–165.

    Article  PubMed  Google Scholar 

  13. Petz LD, Garratty G, Calhoun L, Clark BD, Terasaki PI, Gresens C et al. Selecting donors of platelets for refractory patients on the basis of HLA antibody specificity. Transfusion 2000; 40: 1446–1456.

    Article  CAS  PubMed  Google Scholar 

  14. Klumpp TR, Herman JH, Gaughan JP, Russo RR, Christman RA, Goldberg SL et al. Clinical consequences of alterations in platelet transfusion dose: a prospective, randomized, double-blind trial. Transfusion 1999; 39: 674–681.

    Article  CAS  PubMed  Google Scholar 

  15. Brecher ME, Goodnough LT . Clinical consequences of alterations in platelet transfusion dose: a prospective, randomized, double-blind trial (letter). Transfusion 2000; 40: 383.

    Article  CAS  PubMed  Google Scholar 

  16. Zeger G, Williams CT, Shulman IA . Single donor platelets: can we afford to use them? Can we afford not to use them? Transfus Sci 1997; 18: 585–588.

    Article  CAS  PubMed  Google Scholar 

  17. Ness PM, Campbell-Lee SA . Single donor versus pooled random donor platelet concentrates. Curr Opin Hematol 2001; 8: 392–396.

    Article  CAS  PubMed  Google Scholar 

  18. Brubaker DB, Marcus C, Holmes E . Intravascular and total body equilibrium in healthy volunteers and in thrombocytopenic patients transfused with single donor platelets. Am J Hematol 1998; 58: 165–176.

    Article  CAS  PubMed  Google Scholar 

  19. Bishop JF, Matthews JP, Yuen K, McGrath M, Wolf MM, Szer J . The definition of refractoriness to platelet transfusions. Transfusion Med 1992; 2: 35–41.

    Article  CAS  Google Scholar 

  20. Sweeney JD, Petrucci J, Yankee R . Pooled platelet concentrates: maybe not fancy, but fiscally sound and effective. Transfus Sci 1997; 18: 575–583.

    Article  CAS  PubMed  Google Scholar 

  21. Bernstein SH, Nademanne AP, Vose JM, Tricot G, Fay JW, Negrin RS et al. A multicenter study of platelet recovery and utilization in patients after myeloablative therapy and hematopoietic stem cell transplantation. Blood 1998; 9: 3509–3517.

    Google Scholar 

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Correspondence to M de Lima.

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Gurkan, E., Patah, P., Saliba, R. et al. Efficacy of prophylactic transfusions using single donor apheresis platelets versus pooled platelet concentrates in AML/MDS patients receiving allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 40, 461–464 (2007). https://doi.org/10.1038/sj.bmt.1705751

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