Severe CD4+ T‐cell lymphopenia is not observed in frequent plateletpheresis donors collected on the Fenwal Amicus

Gansner, John M.; Papari, Mona; Goldstein, J.; Gaufberg, Rachel A.; Neuberg, Donna; Makar, Robert S.; Kaufman, Richard M.

doi:10.1111/trf.15441

Cited by 5 publications

(6 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our study suggests that the type of cell separator used has an impact on donor lymphocyte loss. While Gansner et al 11 observed donation frequency‐dependent CD4 + and CD8 + T‐cell lymphopenia in frequent plateletpheresis donors processed with the LRS‐based Trima Accel system, no severe CD4+ T‐cell lymphopenia in frequent plateletpheresis donors whose cells were collected with the non‐LRS Fenwal Amicus system in another trial 27 . Rhamani et al, 28 who examined the relationship between lymphocyte counts and plateletpheresis with the LRS‐based Trima Accel, also found CD4+ T‐cell lymphopenia in previous frequent apheresis platelet donors who had not donated for at least 1 year.…”

Section: Discussionmentioning

confidence: 94%

Total platelet donation count and donation frequency are determinants of plateletpheresis‐associated lymphopenia

et al. 2021

View full text Add to dashboard Cite

Background Plateletpheresis using a leukocyte reduction system (LRS) traps donor WBCs in the LRS chamber, which may lead to lymphopenia, especially in frequent plateletpheresis donors. It seems plausible that this might cause adverse effects. However, current knowledge about potential confounders and donor health impacts is incomplete. Donors and methods Recent platelet donors and donations collected at University Hospital Regensburg from 2016 to 2019 using the Terumo BCT Trima Accel LRS system were retrospectively analyzed and compared with historical platelet donors and donations collected mainly with Fresenius Kabi Amicus non‐LRS system from 2010 to 2013. Additionally, recent donors were prospectively surveyed using a health‐related topics questionnaire. Results Analysis of 819 recent donors with 11,254 blood counts and 1464 questionnaires and 1011 historical donors with 12,848 blood counts revealed that increased annual platelet donation frequencies were associated with decreased lymphocyte counts in both groups. Median lymphocyte counts in recent donors with no versus ≥24 previous annual donations declined from 2.0 to 1.2 × 103/μL (p < 2.2 × 10−16), and those in historical donors with no versus ≥24 previous annual donations decreased from 2.0 to 1.5 × 103/μL (p = 6 × 10−4), respectively. The questionnaire results showed that donation frequency and lymphopenia were not associated with upper respiratory tract infection (URTI) incidence or duration, but platelet donors who concomitantly donated granulocytes had significantly shorter URTI durations than those who did not (p = .008). Conclusion This study confirmed that plateletpheresis‐associated lymphopenia occurs in LRS and to a lesser degree in non‐LRS platelet donors, but revealed no evidence of a negative impact on donor health.

show abstract

Section: Discussionmentioning

confidence: 94%

Total platelet donation count and donation frequency are determinants of plateletpheresis‐associated lymphopenia

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Recently, it has been observed that frequent platelet donors can develop severe T‐cell lymphopenia without obvious clinical sequelae 2 . Initial studies suggested that lymphopenia occurs in platelet donors with more than 50 lifetime donations, 2 and that lymphopenia occurs primarily 3 —or perhaps exclusively 4 —in donors collected with the Trima Accel instrument (Terumo BCT, Lakewood, CO). The Trima instrument uses a leukocyte reduction system (LRS) chamber to trap white blood cells (WBCs), yielding leukoreduced platelet units.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for T‐cell lymphopenia in frequent platelet donors: The BEST collaborative study

Kaufman,

Marks,

Flamand

et al. 2023

Transfusion

Self Cite

View full text Add to dashboard Cite

BackgroundSevere T‐cell lymphopenia of uncertain clinical significance has been observed in frequent apheresis platelet donors. Two commonly used plateletpheresis instruments are the Trima Accel, which uses a leukoreduction system (LRS) chamber to trap leukocytes and the Fenwal Amicus, which does not use an LRS chamber.Study Design and MethodsWe performed an international, multicenter, observational study comparing T‐cell populations in frequent platelet donors collected exclusively using the Trima instrument (n = 131) or the Amicus instrument (n = 77). Age‐ and sex‐matched whole blood donors (n = 126) served as controls.ResultsCD4+ T‐cell counts <200 cells/μL were found in 9.9% of frequent Trima (LRS+) platelet donors, 4.4% of frequent Amicus (LRS−) platelet donors, and 0 whole blood donors (p < .0001). CD4+ T‐cell counts <200 cells/μL were only seen in platelet donors with ≥200 lifetime donations. In multivariable analysis, age, lifetime donations, and instrument (Trima vs. Amicus) were independent risk factors for lymphopenia. In 40 Trima platelet donors, a plasma rinseback procedure was routinely performed following platelet collections. No Trima platelet donors receiving plasma rinseback had a CD4+ T‐cell count <200 cells/μL versus 13/91 Trima platelet donors not receiving plasma rinseback (p = .01).DiscussionRecurrent bulk lymphocyte removal appears to contribute to the development of T‐cell lymphopenia in frequent, long‐term platelet donors. Lymphopenia is more common when an LRS chamber is used during platelet collection but can occur without an LRS chamber. Blood centers using LRS chambers can mitigate donor lymphopenia by performing plasma rinseback.

show abstract

“…This issue was revisited in a 2019 study showing that 30% of frequent plateletpheresis donors had severe CD4+ T‐cell lymphopenia (<200 × 10 6 cells/L), which is typically only seen in the context of severe immunodeficiency such as HIV infection 10 . The plateletpheresis‐associated lymphopenia was shown to persist for at least a year after ceasing donations 11 . These findings, reported from a center using a leukoreduction system (LRS) chamber with the Trima Accel system, were not replicated among frequent donors using a different leukoreduction mechanism 12 .…”

Section: Introductionmentioning

confidence: 99%

Frequent platelet donation is associated with lymphopenia and risk of infections: A nationwide cohort study

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background Recently, plateletpheresis donations using a widely used leukoreduction system (LRS) chamber have been associated with T‐cell lymphopenia. However, clinical health consequences of plateletpheresis‐associated lymphopenia are still unknown. Study Design and Methods A nationwide cohort study using the SCANDAT3‐S database was conducted with all platelet‐ and plasmapheresis donors in Sweden between 1996 and 2017. A Cox proportional hazards model, using donations as time‐dependent exposures, was used to assess the risk of infections associated with plateletpheresis donations using an LRS chamber. Results A total of 74 408 apheresis donors were included. Among donors with the same donation frequency, plateletpheresis donors using an LRS chamber were at an increased risk of immunosuppression‐related infections and common bacterial infections in a dose‐dependent manner. While very frequent donors and infections were rare in absolute terms resulting in wide confidence intervals (CIs), the increased risk was significant starting at one‐third or less of the allowed donation frequency in a 10‐year exposure window, with hazard ratios reaching 10 or more. No plateletpheresis donors that used an LRS chamber experienced a Pneumocystis jirovecii, aspergillus, disseminated mycobacterial, or cryptococcal infection. In a subcohort (n = 42), donations with LRS were associated with low CD4+ T‐cell counts (Pearson's R = −0.41; 95% CI, − 0.63 to −0.12). Conclusion Frequent plateletpheresis donation using an LRS chamber was associated with CD4+ T‐cell lymphopenia and an increased risk of infections. These findings suggest a need to monitor T‐lymphocyte counts in frequent platelet donors and to conduct future investigations of long‐term donor health and for regulators to consider steps to mitigate lymphodepletion in donors.

show abstract

Severe CD4+ T‐cell lymphopenia is not observed in frequent plateletpheresis donors collected on the Fenwal Amicus

Cited by 5 publications

References 5 publications

Total platelet donation count and donation frequency are determinants of plateletpheresis‐associated lymphopenia

Total platelet donation count and donation frequency are determinants of plateletpheresis‐associated lymphopenia

Risk factors for T‐cell lymphopenia in frequent platelet donors: The BEST collaborative study

Frequent platelet donation is associated with lymphopenia and risk of infections: A nationwide cohort study

Contact Info

Product

Resources

About