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Effective prophylaxis against platelet refractoriness in multitransfused
patients by use of leukocyte-free blood components
UM Saarinen, R Kekomaki, MA Siimes and G Myllyla
Children's Hospital, University of Helsinki, Finland.
Development of permanent platelet refractoriness is a major problem in
multitransfused patients with diseases such as leukemia, aplastic anemia,
or pediatric solid tumors. We tried to prevent alloimmunization in these
patients by systematic use of leukocyte-free blood components with less
than one million of contaminating leukocytes per unit of platelets or red
cells. Our study group comprised 26 patients with a minimum of 10 platelet
transfusions per patient. These patients were compared with a historical
reference group of 21 patients who had received standard blood products. In
the leukocyte-free group none developed platelet refractoriness, in
contrast to the reference group where 11 of the 21 patients became
refractory to random platelets. The median corrected platelet increment for
random pooled platelets was significantly higher in the leukocyte-free
group compared with the reference group. The increasing number of
transfusions did not correlate with the development of platelet
refractoriness; instead we propose that the lower limit of antigenic
exposure is important. We conclude that systematic use of leukocyte-free
blood components effectively prevents development of platelet
refractoriness and contributes to optimal supportive care of children with
cancer.
Volume 75,
Issue 2,
pp. 512-517,
01/15/1990
Copyright © 1990 by The American Society of Hematology
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