Economic Impact of Donor Platelet Count and Platelet Yield in Apheresis Products: Relevance for Emerging Issues in Platelet Transfusion Therapy

Goodnough, Lawrence T.; Ali, Suhail M.; Despotis, George; Dynis, Marian; DiPersio, John F.

doi:10.1159/000031018

Cited by 18 publications

(29 citation statements)

References 19 publications

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“…10,11 The increased platelet count resulted in increased platelet apheresis yields. Although this response had been predicted by previous studies over a narrow range of donor platelet counts, 8,23 our studies have confirmed and extended this principle over an extensive range of donor platelet counts. The linearity of the response of platelet yield to platelet count (Figure 2) showed no evidence of reaching a plateau even at platelet counts up to 901 ϫ 10 9 /L.…”

Section: Discussionsupporting

confidence: 85%

“…The average yield of platelets collected by platelet apheresis is approximately 4.2 ϫ 10 11 platelets. 1,7,8 The platelet yield depends on many factors, but with current automated technologies, the donor's preapheresis count, total blood volume, and the duration of the procedure are the predominant determinants. 7,8 Donor comfort and convenience limit the last parameter.…”

Section: Introductionmentioning

confidence: 99%

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Thrombopoietin therapy increases platelet yields in healthy platelet donors

Kuter

Goodnough

Romo

et al. 2001

Blood

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The recombinant thrombopoietins have been shown to be effective stimulators of platelet production in cancer patients. It was therefore of interest to determine if one of these, pegylated recombinant human megakaryocyte growth and development factor (PEG-rHuMGDF), could be used to increase platelet counts and consequently platelet yields from apheresis in healthy platelet donors. In a blinded, 2-cycle, crossover study, 59 platelet donors were randomized to receive a single subcutaneous injection of PEG-rHuMGDF (1 g/kg or 3 g/kg) or placebo and 15 days later undergo platelet apheresis. Donors treated with placebo had a median peak platelet count after PEG-rHuMGDF injection of 248 ؋ 10 9 /L compared with 366 ؋ 10 9 /L in donors treated with 1 g/kg PEG-rHuMGDF and 602 ؋ 10 9 /L in donors treated with 3 g/kg PEG-rHuMGDF. The median maximum percentage that platelet counts increased from baseline was 10% in donors who received placebo compared with 70% in donors who received 1 g/kg and 167% in donors who received 3 g/kg PEG-rHuMGDF. There was a direct relationship between the platelet yield and the preapheresis platelet count: Placebo-treated donors provided 3.8 ؋ 10 11 (range 1.3 ؋ 10 11 -7.9 ؋ 10 11 ) platelets compared with 5.6 ؋ 10 11 (range 2.6 ؋ 10 11 -12.5 ؋ 10 11 ) or 11.0 ؋ 10 11 (range 7.1 ؋ 10 11 -18.3 ؋ 10 11 ) in donors treated with 1 g/kg or 3 g/kg PEG-rHuMGDF, respectively. Substandard collections (<3 ؋ 10 11 platelets) were obtained from 26%, 4%, and 0% of the placebo, 1 g/kg, and 3 g/kg donors, respectively. No serious adverse events were reported; nor were there events that met the criteria for dose-limiting toxicity. Thrombopoietin therapy can increase platelet counts in healthy donors to provide a median 3-fold more apheresis platelets compared with untreated donors. (Blood. 2001;98:1339-1345)

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Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Thrombopoietin therapy increases platelet yields in healthy platelet donors

Kuter

Goodnough

Romo

et al. 2001

Blood

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“…19 Apheresis products containing 7 ϫ 10 11 to 18 ϫ 10 11 platelets have the potential to be split into 2 to 6 platelet transfusion products, so that many patients could potentially benefit from one apheresis procedure; costs per apheresis platelet product would be reduced substantially. 20 However, if transfusion of a very large number of platelets results in an increased interval between transfusions and, most important, fewer total platelet transfusion events during a treatment course, it might be a preferable strategy to frequent transfusions at lower doses. A recent prospective, randomized trial found that when compared to the administration of lower dose platelets (mean, 3.1 ϫ 10 11 *Data are for unique, first study transfusion only recipients.…”

Section: Discussionmentioning

confidence: 99%

Prophylactic platelet transfusions from healthy apheresis platelet donors undergoing treatment with thrombopoietin

Goodnough

Kuter

McCullough

et al. 2001

Blood

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Many patients receiving dose-intensive chemotherapy acquire thrombocytopenia and need platelet transfusions. A study was conducted to determine whether platelets harvested from healthy donors treated with thrombopoietin could provide larger increases in platelet counts and thereby delay time to next platelet transfusion compared to routinely available platelets given to thrombocytopenic patients. Community platelet donors received either 1 or 3 g/kg pegylated recombinant human megakaryocyte growth and development factor (PEG-rHuMGDF) or placebo and then donated platelets 10 to 15 days later. One hundred sixty-six of these platelet concentrates were then transfused to 120 patients with platelets counts 25 ؋ 10 9 /L or lower. Pretransfusion platelet counts (11 ؋ 10 9 /L) were similar for recipients of placebo-derived and PEG-rHuMGDF-derived platelets. Early after transfusion, the median platelet count increment was higher in patients receiving PEG-rHuMGDF-derived platelets: 19 (range, ؊12-66) ؋ 10 9 /L, 41 (range, 5-133) ؋ 10 9 /L, and 82 (range, ؊4-188) ؋ 10 9 /L for placebo-, 1-g/kg-, and 3-/kg-derived platelets, respectively. This difference was maintained 18 to 24 hours after transfusion. Transfusion-free intervals were 1.72, 2.64, and 3.80 days for the recipients of the placebo-, 1-g/ kg-, and 3-/kg-derived platelets, respectively. The rate of transfusion-related adverse events was not different in recipients of placebo-derived and PEG-rHuMGDFderived platelets. Therefore, when transfused into patients with thrombocytopenia, platelets collected from healthy donors undergoing thrombopoietin therapy were safe and resulted in significantly greater platelet count increments and longer transfusionfree intervals than platelets obtained from donors treated with placebo. (Blood. 2001;

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“…While in each study the average platelet dose utilized can be calculated, standard deviations approach 25% of the mean, so that the range of platelet doses transfused is very broad. In an evaluation of our own hospital-based apheresis program, 32% of products contained between 3 and 4 x 10 11 platelets and 32% of platelets contained between 4 and 5 x 10 11 platelets 15 . However, 20% of products exceeded 5 x 10 11 , whereas 12% contained < 3 x 10 11 platelets 15 .…”

Section: Platelet Dosementioning

confidence: 99%

“…In an evaluation of our own hospital-based apheresis program, 32% of products contained between 3 and 4 x 10 11 platelets and 32% of platelets contained between 4 and 5 x 10 11 platelets 15 . However, 20% of products exceeded 5 x 10 11 , whereas 12% contained < 3 x 10 11 platelets 15 . Secondly, leucodepletion of both apheresis platelets and platelet concentrates results in a loss of approximately 20% of platelets 9 .…”

Section: Platelet Dosementioning

confidence: 99%