Clinical consequences of alterations in platelet transfusion dose: a prospective, randomized, double‐blind trial

Klumpp, Thomas R.; Herman, Jay H.; Gaughan, John; Russo, R; Christman, Robert; Goldberg, Steven L.; Ackerman, Stacey J.; Bleecker, Giselle C.; Mangan, KF

doi:10.1046/j.1537-2995.1999.39070674.x

Cited by 105 publications

(84 citation statements)

References 36 publications

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“…30 Importantly, the responses to test and reference platelet concentrates were comparable over the range of platelet doses used in clinical practice, and average test and reference 1-and 24-hour count increment and CCI were within previously reported ranges for similar patient populations. 16,17,26 In comparison with other recent studies examining the effect of platelet dose on the interval to the next transfusion, 17,29 test platelets in the present study demonstrated transfusion intervals within reported ranges.…”

Section: Discussionsupporting

confidence: 61%

“…Both test and reference platelet count increments were within reported therapeutic ranges. 16,17 When the 1-hour count increment was adjusted for differences in platelet dose using the CCI, the mean 1-hour CCI was not statistically significantly different between treatment groups (13 100 Ϯ 5400 vs 14 900 Ϯ 6200, P ϭ .11), with a mean difference of 1800 (95% CI, Ϫ400 to 4100). By longitudinal regression analysis for all transfusions, platelet concentrates prepared with and without PCT did not differ significantly with respect to the 1-hour posttransfusion platelet count in cycle 1 (P ϭ .53).…”

Section: Platelet Count Increments 1 Hour After Transfusionmentioning

confidence: 98%

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Transfusion of pooled buffy coat platelet components prepared with photochemical pathogen inactivation treatment: the euroSPRITE trial

Rhenen

Gulliksson

Cazenave

et al. 2002

Blood

290

444

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A nucleic acid-targeted photochemical treatment (PCT) using amotosalen HCl (S-59) and ultraviolet A (UVA) light was developed to inactivate viruses, bacteria, protozoa, and leukocytes in platelet components. We conducted a controlled, randomized, double-blinded trial in thrombocytopenic patients requiring repeated platelet transfusions for up to 56 days of support to evaluate the therapeutic efficacy and safety of platelet components prepared with the buffy coat method using this pathogen inactivation process. A total of 103 patients received one or more transfusions of either PCT test (311 transfusions) or conventional reference (256 transfusions) pooled, leukoreduced platelet components stored for up to 5 days before transfusion. More than 50% of the PCT platelet components were stored for 4 to 5 days prior to transfusion. The mean 1-hour corrected count increment for up to the first 8 test and reference transfusions was not statistically significantly different between treatment groups (13 100 ؎ 5400 vs 14 900 ؎ 6200, P ‫؍‬ .11). By longitudinal regression analysis for all transfusions, equal doses of test and reference components did not differ significantly with respect to the 1-hour (95% confidence interval [CI], ؊3.1 to 6.1 ؋ 10 9 / L, P ‫؍‬ .53) and 24-hour (95% CI, ؊1.3 to 6.5 ؋ 10 9 /L, P ‫؍‬ .19) posttransfusion platelet count. Platelet transfusion dose, pretransfusion storage duration, and patient size were significant covariates (P < .001) for posttransfusion platelet counts. Clinical hemostasis, hemorrhagic adverse events, and overall adverse events were not different between the treatment groups. Platelet components prepared with PCT offer the potential to further improve the safety of platelet transfusion using technology compatible with current methods to prepare buffy coat platelet components. (Blood. 2003;101: 2426-2433)

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Section: Discussionsupporting

confidence: 61%

Section: Platelet Count Increments 1 Hour After Transfusionmentioning

confidence: 98%

Transfusion of pooled buffy coat platelet components prepared with photochemical pathogen inactivation treatment: the euroSPRITE trial

Rhenen

Gulliksson

Cazenave

et al. 2002

Blood

290

444

View full text Add to dashboard Cite

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“…The use of SDAP or higher doses of platelets is still controversial and associated with higher costs. 14,15 Some authors advocate the use of SDAP due to less exposure to multiple donors, resulting in smaller risk of contamination with infectious diseases and lower risk of developing alloantibodies. 16,17 However, it is unclear if using SDAP improves outcomes of transfusions, as opposed to using the more readily available pooled platelet concentrates (PPC).…”

Section: Introductionmentioning

confidence: 99%

Efficacy of prophylactic transfusions using single donor apheresis platelets versus pooled platelet concentrates in AML/MDS patients receiving allogeneic hematopoietic stem cell transplantation

Gürkan

Patah

Saliba

et al. 2007

Bone Marrow Transplant

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Superiority of single-donor apheresis platelets (SDAP) over pooled platelet concentrates (PPC) transfusions is largely assumed, but unproven. We hypothesized that prophylactic SDAP and PPC transfusions are clinically equivalent after allogeneic hematopoietic stem cell transplants (HSCT). We studied all transfusions administered to 33 patients with AML/MDS during the first 100 days after busulfan-based, myeloablative HSCT. All donorrecipient pairs were ABO identical. Transfusion threshold was a platelet count p15 Â 10 9 /l. The corrected increment (CCI) was used for all comparisons. Median time to platelet engraftment was 13 days (n ¼ 30). PPC transfusions (n ¼ 105) were ABO compatible, while 10% of 41 SDAP were not (P ¼ 0.006). Median post-transfusion platelet count was 51K/ll (5-118K) after SDAP and 36K/ll (3-115K) after PPC (P ¼ 0.0004). Median CCI was 14.178 (SDAP) versus 7.793 (PPC) (P ¼ 0.0001). Median time to another transfusion was 3 days (SDAP) and 2 days (PPC; P ¼ 0.3). In the week following any given transfusion, the median number of new transfusions was similar (n ¼ 2), as well as the need of further transfusion (16 versus 24%, P ¼ 0.2). A total of 17% of SDAP and 30% of PPC transfusions were labeled 'ineffective' (P ¼ 0.1). There were two non-lethal hemorrhage episodes (6%). SDAP transfusions produced better platelet counts, but SDAP and PPC were equally effective in preventing hemorrhage.

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“…Only in the late 1990s and early part of the twenty-first century were various studies done to try to establish an optimal prophylactic platelet count threshold for prophylactic platelet transfusions in thrombocytopenic patients. 8,10,11,12,13 The most widely quoted trial, which used a lower prophylactic trigger of 10×10 9 /L versus 20×10 9 /L, was evaluated in a multicenter, randomized clinical trial (RCT). 10 This group studied adult patients receiving induction therapy for newly diagnosed AML.…”

Section: Prophylactic Platelet Transfusionsmentioning

confidence: 99%

Platelet Transfusion Therapy

Karim

Hoque²,

Hoque

et al. 2017

Anwer Khan Mod Med Coll J

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Patients with severe thrombocytopenia are presumed to be at increased risk for bleeding, and consequently it has been standard practice for the past four decades to give allogeneic platelet transfusions to severely thrombocytopenic patients as supportive care. Platelet transfusions may be given either prophylactically to reduce the risk of bleeding, in the absence of clinical hemorrhage (prophylactic transfusions), or to control active bleeding when present (therapeutic transfusions). Platelets for transfusion can be prepared either by separation of units of platelet concentrates (PCs) from whole blood, which are pooled before administration, or by apheresis from single donors. Comparative studies have shown that the post transfusion increments, hemostatic benefit, and side effects are similar with either product. Thus, in routine circumstances, they can be used interchangeably. In most centers, pooled PCs are less costly. Single-donor platelets from selected donors are preferred when histocompatible platelet transfusions are needed. Both preparations can be stored for up to 5 days after collection at 20°C to 24°C with good maintenance of platelet viability. It is now uncommon for patients undergoing intensive chemotherapy or bone marrow transplantation to die of hemorrhage, but it is open to debate as to what degree platelet transfusions have been responsible for this change in outcome, given the many other advances in other aspects of supportive care.Anwer Khan Modern Medical College Journal Vol. 6, No. 2: July 2015, P 40-46

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Clinical consequences of alterations in platelet transfusion dose: a prospective, randomized, double‐blind trial

Cited by 105 publications

References 36 publications

Transfusion of pooled buffy coat platelet components prepared with photochemical pathogen inactivation treatment: the euroSPRITE trial

Transfusion of pooled buffy coat platelet components prepared with photochemical pathogen inactivation treatment: the euroSPRITE trial

Efficacy of prophylactic transfusions using single donor apheresis platelets versus pooled platelet concentrates in AML/MDS patients receiving allogeneic hematopoietic stem cell transplantation

Platelet Transfusion Therapy

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