Effectiveness of Red Blood Cells Filtered Through Cotton Wool to Prevent Antileukocyte Antibody Production in Multitransfused Patients

Abstract

The effectiveness of red blood cells made leukocyte-free by filtration through cotton wool to prevent the production of antileukocyte antibodies was evaluated in children suffering from Cooley’s anemia. Two studies were performed: study I was carried out prospectively in two groups of non transfused patients, one group treated with leukocyte-free filtered red cells, the other with buffy-coat-free packed red cell units. Different types of antileukocyte antibodies were looked for in both groups and the results were compared. In study II the behavior of pre-existing lymphocytotoxic antibodies found in the serum of children previously transfused with standard or buffy-coat-free packed red cell units was followed after the patients had been passed to a program of transfusion with leukocyte-free filtered red cells. Study I showed that none of the patients transfused with leukocyte-free filtered red cell units have produced antileukocyte antibodies, while these could be found in 2/3 of the patients transfused with buffy-coat-free packed red cell units. Study II showed that the repeated transfusion of leukocyte-free filtered red cells to patients who possessed in their serum preformed lymphocytotoxic antibodies did not cause any increase in the potency or spectrum of these antibodies, but was in fact accompanied in some cases by their decrease or disappearance. It is concluded that filtration through cotton wool is an easy and inexpensive means of preparing leukocyte-free red blood cells for transfusion capable of preventing (or reducing) the production of antileukocyte antibodies in multitransfused patients.

The Clinical Importance of Leukocyte Depletion in Regular Erythrocyte Transfusions

“…In a previous investigation [ 11 ] we saw that the transfusion of leukocyte-free red cells prepared by filtration through Erypur filters to previously untrans fused homozygous ß-thalassemics did not induce the pro duction of antileukocyte and antiplatelet antibodies in 9-34 blood transfusions.…”

“…Antilymphocyte, antigranulo cyte, and antiplatelet alloantibodies were detected as previously reported in detail [11]. Briefly, the long incubation lymphocytotoxicity (LCT) [19], indirect granulocyte (GIFT) [20], and indirect platelet immunofluorescence tests (PSIFT) [21] were used to test the patients' sera against a panel of 12 group O donors covering all common HLA-A, -B specificities (antigen frequency higher than 2.5%).…”

Amount and Type of Leukocytes in ‘Leukocyte-Free’ Red Cell and Platelet Concentrates

“…Their presence may seriously complicate platelet transfusions as well as bone marrow and kidney trans plantations. The immunization would perhaps be pre vented if most of the leukocytes could be removed from the blood components [1][2][3].…”

“…The most effective removal of leukocytes from red cells is a combination of buffy coat removal with filtration [1], Recently, cotton wool filtration has also been shown to be highly efficient in reducing leukocyte contamination in platelet concen trates [4], The best leukocyte-poor red cell and platelet concen trates are usually said to contain less than 1-2% of the original number of leukocytes. The products are often called 'leukocyte-free' to distinguish them from the leu kocyte-poor cell concentrates with about 10-fold greater leukocyte contamination.…”

Time Dependent Release of Interleukin-8 and Tumor Necrosis Factor-α in Platelet Concentrate

“…There are many leucocytes in the PC that evoke the formation of antibodies against histocompatibility antigens [9][10][11].Formation of such antibodies occur if the platelets are contaminated with leukocytes but as suggested by Gouttefangeas et al [12] platelets alone are capable of inducing a secondary immune response. Evidence shows that to avoid primary immunization the total number of leucocytes transfused in red cell or platelet concentrate must be \5 9 10 6 [13][14][15]. Role of leucocytes in cytokine release has been understood since long.…”