Transfusion of pathogen‐reduced platelet components without leukoreduction
| Autor: | Wai Chiu Tsoi, Laurence Corash, Albert K. W. Lie, Claudia Koontz, Amy Yingjie Liu, Hans Vermeij, Cheuk-Kwong Lee, Rock Leung, Adonis Stassinopoulos, Joycelyn Sim, Norman Huang, Richard J. Benjamin, Clarence C.K. Lam |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Blood Platelets Male medicine.medical_specialty Ultraviolet Rays Immunology Graft vs Host Disease Disease Antisepsis Platelet Transfusion 030204 cardiovascular system & hematology Gastroenterology Cohort Studies 03 medical and health sciences Leukocyte Count 0302 clinical medicine Internal medicine Furocoumarins medicine Blood-Borne Pathogens Leukocytes Immunology and Allergy Humans Platelet Pathogen business.industry Transfusion Medicine Case-control study Transfusion Reaction Hematology Middle Aged Disinfection Leukoreduction surgical procedures operative Infectious disease (medical specialty) Gamma Rays Case-Control Studies Cohort Virus Inactivation Female business 030215 immunology Cohort study |
| Zdroj: | Transfusion |
| ISSN: | 1537-2995 0041-1132 |
| Popis: | Background Leukoreduction (LR) of platelet concentrate (PC) has evolved as the standard to mitigate risks of alloimmunization, clinical refractoriness, acute transfusion reactions (ATRs), and cytomegalovirus infection, but does not prevent transfusion-associated graft-versus-host disease (TA-GVHD). Amotosalen-ultraviolet A pathogen reduction (A-PR) of PC reduces risk of transfusion-transmitted infection and TA-GVHD. In vitro data indicate that A-PR effectively inactivates WBCs and infectious pathogens. Study design and methods A sequential cohort study evaluated A-PR without LR, gamma irradiation, and bacterial screening in hematopoietic stem cell transplant (HSCT) recipients. The first cohort received conventional PC (control) processed without LR, but with gamma irradiation and bacterial screening. The second cohort received A-PR PC (test) processed without: LR, bacterial screening, or gamma irradiation. The primary efficacy outcome was the 1-hour corrected count increment. The primary safety outcome was treatment-emergent ATR. Secondary outcomes included clinical refractoriness, and 100-day status for engraftment, TA-GVHD, HSCT-GVHD, infections, and mortality. Results Mean corrected count increment (× 103 ) of 33 test PC recipients was similar (18.9 ± 8.8 vs. 16.6 ± 8.4; p = 0.296) to that of 31 control PC recipients. Test recipients had a reduced, but nonsignificant, incidence of ATR (test = 9.1%, Control = 19.4%; p = 0.296). The frequencies of clinical refractoriness (0 of 33 vs. 4 of 31 patients) and refractory transfusions (6.6% vs. 19.3%) were lower in the test cohort (p = 0.05 and 0.02), respectively. No patient in either cohort had TA-GVHD. Day 100 engraftment, HSCT-GVHD, mortality, and infectious disease complications were similar between cohorts. Conclusions This study indicated that A-PR PC without LR, gamma irradiation, or bacterial screening is feasible for support of HSCT. |
| Databáze: | OpenAIRE |
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