White cell reduction in platelet concentrates and packed red cells by filtration: a multicenter clinical trial. The Trap Study Group

Kao, Kuo-Jang; Mickel, Mary; Braine, Hayden G.; Davis, Kathryn; Enright, H; Gernsheimer, Terry; Gillespie, Mary Jo; Kickler, Thomas S.; Lee, Edward J.; McCullough, Jeffrey; McFarland, Janice G.; Nemo, George J.; Noyes, Ward D.; Schiffer, Charles A.; Sell, Kenneth W.; Slichter, Sherrill J.; Woodson, Robert D.

doi:10.1046/j.1537-2995.1995.35195090653.x

Cited by 96 publications

(51 citation statements)

References 17 publications

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“…Thus, leukocyte reduction results in improved quality [19], but also in the loss of 10–20% of platelets [6, 12]. This loss may increase, if clogging phenomena of the filter or previous platelet activation occur [20, 21]. …”

Section: Discussionmentioning

confidence: 99%

Quality and Safety of& ;Platelet Apheresis Concentrates Produced with a New Leukocyte Reduction System

et al. 1998

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Objectives: Contaminating white blood cells (WBC) in apheresis platelet concentrates (PC) can cause a variety of adverse effects after platelet transfusion. To obtain PCs with low WBC contamination, a new leukoreduction system (LRS) utilizing ‘fluidized particle bed’ technology has recently been introduced. Methods: We prospectively examined the effect of LRS apheresis on the donor, the quality of the resulting PCs (n = 120), and the platelet increment in the corresponding recipients. Conventionally prepared apheresis PCs served as control group (n = 27). Platelet glycoproteins were examined by flow cytometry. Results: In LRS apheresis, we observed no serious adverse effects on the donors, but the postdonation absolute lymphocyte counts were reduced from 1,787±505/μl to 1,405±383/μl (p < 0.001). Comparable results were seen in non-LRS donors. The collection efficiency of the LRS procedures was 50.0±7.6%, resulting in a yield of 4.3±1.0 × 10¹¹ platelets/PC. In flow cytometry, platelet glycoproteins in LRS PCs were not elevated: mean fluorescence of CD62 (6±4) or CD63 (9±3) in comparison with non-LRS PCs (mean fluorescence of CD62: 7±4, CD63: 8±3). Median leukocyte contamination of the LRS PCs was 0.41 × 10⁵ (range 0.07–8.5) WBCs/unit. In 43 recipients, the 24-hour corrected count increments after transfusion of LRS PCs (12,530±8,761) were essentially the same as those of 20 recipients of non-LRS PCs (13,133±9,812; p = 0.75). Conclusions: LRS apheresis appears to be a safe procedure, which produced effective PCs with few contaminating leukocytes. With new apheresis technology, filtration of PCs may become superfluous.

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Section: Discussionmentioning

confidence: 99%

Quality and Safety of& ;Platelet Apheresis Concentrates Produced with a New Leukocyte Reduction System

et al. 1998

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“…[1][2][3]5,7,8 Prestorage leukoreduction is performed in the blood collection center using standard operating procedures and quality controls, which should result in less failure of leukoreduction, detected in 5% or more of blood components filtered at the bedside during clinical trials. 17,19,20 In addition, prestorage leukoreduction will minimize the transfusion of potentially immunogenic white blood cell (wbc) fragments, which accumulate during storage and may not be removed by filtration. 18 Universal prestorage leukoreduction (ULR) of red blood cell and platelet products was instituted by the Canadian Blood Services between November 1997 and August 1999 with the goal of preventing the complications of transfusion associated with "passenger leukocytes."…”

Section: Introductionmentioning

confidence: 99%

Universal prestorage leukoreduction in Canada decreases platelet alloimmunization and refractoriness

Seftel

Growe

Petraszko

et al. 2004

Blood

126

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Randomized controlled trials have shown a reduction in platelet alloimmunization and refractoriness in patients with acute leukemia (AL) with the use of poststorage leukoreduction of blood products. Universal prestorage leukoreduction (ULR) of red cell and platelet products has been performed in Canada since August 1999. We conducted a retrospective analysis of 13 902 platelet transfusions in 617 patients undergoing chemotherapy (CT) for AL or stem cell transplantation (SCT) before (n ‫؍‬ 315) and after (n ‫؍‬ 302) the introduction of ULR. Alloimmunization was significantly reduced (19% to 7%, P < .001) in the post-ULR group. Alloimmune platelet refractoriness was similarly reduced (14% to 4%, P < .001). Fewer patients in the post-ULR group received HLA-matched platelets (14% vs 5%, P < .001). Alloimmunization and alloimmune refractoriness in the 318 patients who were previously pregnant and/or transfused were also reduced after ULR (P ‫؍‬ .023 and P ‫؍‬ .005, respectively). In a Cox regression model, the 3 independent factors that predicted for alloimmune refractoriness were nonleukoreduced blood

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“…This leukoreduction is usually done by filtration [17]. However, filtration leukoreduction of PC not onyl reduces the WBC count in the filtered product but also causes platelet losses of about 20% (10–81%) [18, 19, 20, 21, 22, 23]. It may even sacrifice the complete PC in the case of blocked filters [24, 25].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a Platelet Apheresis Technique for the Preparation of Leukocyte-Reduced Platelet Concentrates

Zingsem¹,

Glaser²,

Weisbach³

et al. 1998

Vox Sanguinis

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Objectives: Reduction of the white blood cell (WBC) contamination in platelet concentrates (PC) protects patients from the immunological and infectious side effects of platelet transfusion caused by WBC. This can be done either by filtration of the PC or by improved apheresis techniques that yield WBC-poor preparations. Methods: To evaluate an improved technique for platelet collection, we carried out 201 separations in 89 healthy cytapheresis donors using the new COBE Spectra leukoreduction system (LRS) and compared the results with those of standard dual-needle separations obtained with the same cell separator. Results: A small but statistically significant difference was found in platelet collection efficiency in comparison with the standard non-LRS software procedures (LRS: 52.6 vs. 56.3% for the reference). However, median WBC contamination was only 0.01 × 10⁶ WBC per LRS product. This significant (p < 0.0005) improvement corresponds to a 10-fold reduction of WBC as compared with the standard dual-needle technique. Conclusions: The COBE Spectra LRS system produced PCs with a platelet collection efficiency nearly equal to previous techniques and with a residual WBC content satisfying even the most stringent criteria for WBC-depleted blood components. As this purity is achieved without important platelet loss, conventional fiber filtration no longer seems necessary in this kind of PC.

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White cell reduction in platelet concentrates and packed red cells by filtration: a multicenter clinical trial. The Trap Study Group

Cited by 96 publications

References 17 publications

Quality and Safety of& ;Platelet Apheresis Concentrates Produced with a New Leukocyte Reduction System

Quality and Safety of& ;Platelet Apheresis Concentrates Produced with a New Leukocyte Reduction System

Universal prestorage leukoreduction in Canada decreases platelet alloimmunization and refractoriness

Evaluation of a Platelet Apheresis Technique for the Preparation of Leukocyte-Reduced Platelet Concentrates

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