Use of non-irradiated blood components in Campath (alemtuzumab)-treated renal transplant patients

Autor:	David Taube, F. Regan, Y. M. T. Hui, M. Willecombe
Rok vydání:	2016
Předmět:	medicine.medical_specialty business.industry Medical record Retrospective cohort study Hematology 030204 cardiovascular system & hematology medicine.disease Blood irradiation therapy Surgery Transfusion-associated graft versus host disease Transplantation 03 medical and health sciences surgical procedures operative 0302 clinical medicine Renal transplant 030220 oncology & carcinogenesis medicine Alemtuzumab Effective treatment business medicine.drug
Zdroj:	Transfusion Medicine. 26:138-146
ISSN:	0958-7578
DOI:	10.1111/tme.12292
Popis:	SUMMARYBackground The prevention of transfusion-associated graft-versus-host disease (TA-GvHD) through the irradiation of components is key as there is no effective treatment. Universal leucodepletion reduces but may not eliminate TA-GvHD; therefore, irradiation is still recommended. In 2010, Campath (alemtuzumab) was added as an indication for irradiation but was not implemented everywhere. Objectives To identify any cases of TA-GvHD in our Campath-conditioned renal transplant patients, who were transfused with non-irradiated components. Methods Retrospective study of Campath-conditioned renal transplant patients transfused with non-irradiated components. In those transfused up to 9 months following Campath who survived to 1-year follow-up, TA-GvHD was excluded. For patients not followed-up for a full year, we reviewed medical records for features of TA-GvHD. For patients transfused after 9 months following Campath, survival of at least 3 months following last transfusion excluded TA-GvHD. Results Six hundred and forty-seven Campath-conditioned renal transplant patients were transfused; 616 were transfused within 9 months following Campath; 601 were alive at 1 year, excluding TA-GvHD. Twelve died and three were not followed-up for a full year, but a review of medical records excluded TA-GvHD. The 31 patients transfused 9 months or longer following Campath were all alive 6 months following the last transfusion, excluding TA-GvHD. Conclusions Despite receiving non-irradiated components, none of the 647 Campath-conditioned renal transplant patients developed TA-GvHD. Further reviews to replicate our data could enable change to guidance, at least in UK where components are leucodepleted, as an unnecessary requirement for irradiated components has both clinical delay and cost implications.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::f1eab53adc75efe5105fabfb2be0ec1f https://doi.org/10.1111/tme.12292 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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