A randomized controlled trial comparing plasma removal with white cell reduction to prevent reactions to platelets

Heddle, Nancy M.; Klama, Luba; Meyer, Ralph M.; Walker, Irwin; Boshkov, Lynn K.; Roberts, Robin S.; Chambers, Shelley; Podlosky, Linda; O’Hoski, Pamela; Levine, Mark

doi:10.1046/j.1537-2995.1999.39399219278.x

Cited by 146 publications

(149 citation statements)

References 19 publications

Supporting

Mentioning

138

Contrasting

Unclassified

Order By: Relevance

“…IL-6 concentrations at day 5 of storage (251 Ϯ 103 pg/mL) were similar to IL-6 levels (214-1088 pg/mL), which have been linked to the genesis of febrile transfusion reactions but not TRALI. 17,22 Concentrations of IL-6 that affected PMNs were several orders of magnitude higher in vitro. 21,23 IL-8 levels were significantly elevated in the implicated WB-PLTs on day 5 only, similar to the levels reported by Stack and Snyder, 40 and at these concentrations IL-8 has been reported to affect PMN function in vitro.…”

Section: Discussionmentioning

confidence: 99%

“…Since cytokines have been implicated in reactions precipitated by the transfusion of WB-PLTs, [17][18][19]22 both IL-6 and IL-8 levels were measured in the implicated WB-PLT units and in both the pre-and posttransfusion plasma samples from TRALI patients. IL-6 levels were increased as a function of the storage time of the implicated platelet concentrates, but did not reach levels statistically different from the plasma levels of healthy control patients until day 5 of storage (day 5, 251.5 Ϯ 103 pg/mL; controls, 1.6 Ϯ 0.9 pg/mL; P Ͻ .05) ( Figure 5A).…”

Section: Measurement Of Il-6 and Il-8 In Implicated Wb-plts And Patiementioning

confidence: 99%

“…[17][18][19] Two of these cytokines, interleukin 6 (IL-6) and interleukin 8 (IL-8), stimulate PMNs and may play a role in TRALI. [17][18][19][20][21][22][23][24] TRALI is clinically identical to the adult respiratory distress syndrome (ARDS), which has been defined as a 2-event, PMNmediated syndrome. 1,9,[25][26][27][28] Therefore, when investigation of the donors in the first 17 TRALI cases failed to identify antileukocyte antibodies, and laboratory examination of 8 recipients (including 2 patients with recurrent TRALI reactions to products from different donors) also was negative for such antibodies, we sought another etiology.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Transfusion-related acute lung injury: epidemiology and a prospective analysis of etiologic factors

Silliman

Boshkov

Mehdizadehkashi

et al. 2003

Blood

Self Cite

533

563

View full text Add to dashboard Cite

Transfusion-related acute lung injury (TRALI) is a life-threatening complication of hemotherapy. We report a series of 90 TRALI reactions in 81 patients secondary to transfusion with whole blood platelets (72 reactions), apheresis platelets (2), packed red cells (15), and plasma (1). The overall prevalence was 1 in 1120 cellular components. To examine the epidemiology of TRALI, we completed a nested case-control study of the first 46 patients with TRALI compared with 225 controls who had received transfusions. We then completed a prospective analysis of possible biologic response modifiers responsible for 51 of the TRALI cases, including human leukocyte antigen (HLA) class I, class II, and granulocyte antibodies in donors and neutrophil (PMN) priming activity in the plasma of the implicated units and recipients. Two groups were at risk: patients with hematologic malignancies (P < .0004) and patients with cardiac disease (P < .0006). TRALI was associated with older platelets (P ‫؍‬ .014). In the prospective study, antileukocyte antibodies were found in only 3.6% of cases. The implicated blood components had greater PMN priming activity than controls (P < .05), and compared with pretransfusion samples, TRALI patients' plasma demonstrated increases in both interleukin 6 (IL-6) and lipid (neutral lipids and lysophosphatidylcholines) priming activity (P < .05). We conclude that TRALI may be more frequent than previously recognized and that patient susceptibility, product age, and increased levels of bioactive lipids in components may predispose patients to TRALI. TRALI, like the acute respiratory distress syndrome, may be a 2-event phenomenon with both recipient predisposition and factors in the stored units playing major roles. (Blood. 2003;101:454-462)

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Measurement Of Il-6 and Il-8 In Implicated Wb-plts And Patiementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Transfusion-related acute lung injury: epidemiology and a prospective analysis of etiologic factors

Silliman

Boshkov

Mehdizadehkashi

et al. 2003

Blood

Self Cite

533

563

View full text Add to dashboard Cite

show abstract

“…35 In the current investigation it was not possible to study another important potential benefit of prestorage leukoreduction (ie, a reduction in FNHTRs) since the method of recording these events at our center changed over the study period. [36][37][38][39][40] Similarly, the other predicted advantages of prestorage leukoreduction, such as a reduction in transfusion-associated infections and posttransfusion immune suppression, require further study. [41][42][43][44] If these benefits are confirmed they will add support to the results of this study and the growing body of literature in favor of prestorage leukoreduction.…”

Section: Discussionmentioning

confidence: 99%

Universal prestorage leukoreduction in Canada decreases platelet alloimmunization and refractoriness

Seftel

Growe

Petraszko

et al. 2004

Blood

126

View full text Add to dashboard Cite

Randomized controlled trials have shown a reduction in platelet alloimmunization and refractoriness in patients with acute leukemia (AL) with the use of poststorage leukoreduction of blood products. Universal prestorage leukoreduction (ULR) of red cell and platelet products has been performed in Canada since August 1999. We conducted a retrospective analysis of 13 902 platelet transfusions in 617 patients undergoing chemotherapy (CT) for AL or stem cell transplantation (SCT) before (n ‫؍‬ 315) and after (n ‫؍‬ 302) the introduction of ULR. Alloimmunization was significantly reduced (19% to 7%, P < .001) in the post-ULR group. Alloimmune platelet refractoriness was similarly reduced (14% to 4%, P < .001). Fewer patients in the post-ULR group received HLA-matched platelets (14% vs 5%, P < .001). Alloimmunization and alloimmune refractoriness in the 318 patients who were previously pregnant and/or transfused were also reduced after ULR (P ‫؍‬ .023 and P ‫؍‬ .005, respectively). In a Cox regression model, the 3 independent factors that predicted for alloimmune refractoriness were nonleukoreduced blood

show abstract

“…PAS displays several advantages over the use of plasma for preparation of PCs. These benefits include reduction of the number of allergic reactions [8,9], while more plasma becomes available for fractioning. Due to the absence of anti-A and anti-B, ABO-incompatible transfusions are better tolerated [10], life-threatening anaphylaxis or febrile nonhemolytic transfusion reactions after transfusion of PCs is a serious clinical problem caused by the sensitizing of recipients to plasma components, such as cytokines [11].…”

Section: Discussionmentioning

confidence: 99%

Clinical Evaluation of Platelet Concentrates Either in Plasma or in Additive Solution

Larrea¹,

Carpio²,

Arbona³

et al. 2008

TOHJ

View full text Add to dashboard Cite

Background and Objectives. Platelet concentrates (PC) obtained from Buffy-Coat (BC) may be diluted in a platelet additive solution (PAS). These PCs may reduce plasma-related adverse reactions. We have tried to assess the relationship between PAS PCs and adverse reactions. Materials and Methods. During 6 months, patients treated with intensive chemotherapy, participated in a prospective study and were randomly assigned to receive, on a prophylactic basis, PCs in either plasma or PAS-2. Five iso-group BCs were pooled diluted in either plasma or PAS-2. One hour after each transfusion, corrected count increments (CCIs) were calculated, presence of hemorrhage and adverse reactions were recorded. Results. Platelet increment, 1-hour platelet count, and corrected count increments (CCI) after transfusion in both groups were similar. There were more transfusion-dependent adverse reactions in plasma group. Conclusion. Use of PAS-2 resulted in less transfusion related reactions; therefore, we recommend synthetic additive solutions to dilute PCs.

show abstract

A randomized controlled trial comparing plasma removal with white cell reduction to prevent reactions to platelets

Abstract: Plasma removal is more effective than poststorage WBC reduction in preventing reactions, especially severe reactions to platelets.

Cited by 146 publications

References 19 publications

Transfusion-related acute lung injury: epidemiology and a prospective analysis of etiologic factors

Transfusion-related acute lung injury: epidemiology and a prospective analysis of etiologic factors

Universal prestorage leukoreduction in Canada decreases platelet alloimmunization and refractoriness

Clinical Evaluation of Platelet Concentrates Either in Plasma or in Additive Solution

Contact Info

Product

Resources

About