A case of transfusion‐associated graft‐versus‐host disease not prevented by white cell‐reduction filters

Akahoshi, M; Takanashi, Minoko; Masuda, Michihiko; Yamashita, Hidetoshi; Hidano, Akira; Hasegawa, Kenji; Kasajima, Takeshi; Shimizu, Mika; Motoji, Toshiko; Oshimi, Kazuo; Mizoguchi, Hideaki

doi:10.1046/j.1537-2995.1992.32292180149.x

Cited by 150 publications

(72 citation statements)

References 12 publications

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“…The referred report corroborates with other works and indicates that even leukocyte-depleted blood products can promote this reaction [37], [38]. Because there is no effective treatment for TA-GVHD [39], [40], irradiation of whole blood and blood components prior to transfusion is the only proven method to prevent the reaction [41], [42].…”

Section: Introductionsupporting

confidence: 87%

Prevention of Transfusion-Associated Graft-versus-Host Disease by Irradiation: Technical Aspect of a New Ferrous Sulphate Dosimetric System

et al. 2013

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Irradiation of whole blood and blood components before transfusion is currently the only accepted method to prevent Transfusion-Associated Graft-Versus-Host-Disease (TA-GVHD). However, choosing the appropriate technique to determine the dosimetric parameters associated with blood irradiation remains an issue. We propose a dosimetric system based on the standard Fricke Xylenol Gel (FXG) dosimeter and an appropriate phantom. The modified dosimeter was previously calibrated using a 60Co teletherapy unit and its validation was accomplished with a 137Cs blood irradiator. An ionization chamber, standard FXG, radiochromic film and thermoluminescent dosimeters (TLDs) were used as reference dosimeters to determine the dose response and dose rate of the 60Co unit. The dose distributions in a blood irradiator were determined with the modified FXG, the radiochromic film, and measurements by TLD dosimeters. A linear response for absorbed doses up to 54 Gy was obtained with our system. Additionally, the dose rate uncertainties carried out with gel dosimetry were lower than 5% and differences lower than 4% were noted when the absorbed dose responses were compared with ionization chamber, film and TLDs.

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Section: Introductionsupporting

confidence: 87%

Prevention of Transfusion-Associated Graft-versus-Host Disease by Irradiation: Technical Aspect of a New Ferrous Sulphate Dosimetric System

et al. 2013

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“…6 Despite the advent of widespread leuko-depletion by either automated collection technologies or filtration, irradiation remains the standard of care for prevention of TA-GVHD. [7][8][9] Currently, cellular blood components for patients thought to be at risk for TA-GVHD are irradiated prior to transfusion in order to prevent this complication. 10 Rare cases due to transfusion of viable leukocytes in fresh frozen plasma have been described as well.…”

mentioning

confidence: 99%

Novel processes for inactivation of leukocytes to prevent transfusion-associated graft-versus-host disease

Corash

Lin

2003

Bone Marrow Transplant

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Summary:Transfusion-associated graft-versus-host disease (TA-GVHD) is a serious complication of blood component transfusion therapy. Currently, cellular blood components for patients recognized at risk for TA-GVHD are irradiated prior to transfusion in order to prevent this complication. Considerable progress has been made in elucidating the pathophysiology of this highly morbid complication, but questions as to which patients are at risk and what is the most robust technology to prevent TA-GVHD remain. As new technologies for inactivating or modulating leukocyte function are introduced, the question of how to evaluate these technologies becomes relevant. Over the past two decades, a number of research groups have explored technology to inactivate infectious pathogens and leukocytes contaminating cellular blood components. Few clinicians have an in-depth understanding of the methods or the criteria for selection of how to approach new technologies for leukocyte inactivation with potential to replace current methods. This mini review focuses on the salient aspects of current and evolving technology for prevention of TA-GVHD.

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“…As patients receiving leukoreduced but non-irradiated blood were found to also suffer from TA-GVHD, leukocyte reduction filters should not be used as prophylaxis against TA-GVHD. The exact number of leukocytes needed to produce TA-GVHD is not known [11]. Physicians should be aware of this devastating complication of blood transfusion in the differential diagnosis of fever accompanied by pancytopenia, elevated liver enzymes, skin rash and diarrhea in a patient with a history of transfusion of nonirradiated blood products from relatives.…”

Section: Discussionmentioning

confidence: 99%

Transfusion-Associated Graft-versus-Host Disease in Patients with and without Immunodeficiency: Report of Six Cases

Aydoğdu¹,

Kaya²,

Karadağ³

et al. 2007

Transfus Med Hemother

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Transfusion-associated graft-versus-host disease (TA-GVHD) is extremely rare compared to transplant- associated GVHD. Mortality in TA-GVHD approaches to 100%. We report six cases with TA-GVHD that were seen during 1994-2004 and discuss the clinical characteristics. Case Reports: Two patients were immunosuppressed, and 4 patients were immunocompetent. All 6 patients were transfused with non-irradiated blood products from relatives before TA-GVHD had occurred. Diagnosis of TA-GVHD in all patients was made based on characteristic clinical manifestations and laboratory findings. All patients died due to TA-GVHD-related complications such as progressive pancytopenia and liver dysfunctions. Conclusion: Our data shows that TA-GVHD is a serious complication of transfusion of blood products among relatives.

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A case of transfusion‐associated graft‐versus‐host disease not prevented by white cell‐reduction filters

Cited by 150 publications

References 12 publications

Prevention of Transfusion-Associated Graft-versus-Host Disease by Irradiation: Technical Aspect of a New Ferrous Sulphate Dosimetric System

Prevention of Transfusion-Associated Graft-versus-Host Disease by Irradiation: Technical Aspect of a New Ferrous Sulphate Dosimetric System

Novel processes for inactivation of leukocytes to prevent transfusion-associated graft-versus-host disease

Transfusion-Associated Graft-versus-Host Disease in Patients with and without Immunodeficiency: Report of Six Cases

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