Factors affecting posttransfusion platelet increments, platelet refractoriness, and platelet transfusion intervals in thrombocytopenic patients
Top Cited Papers
Open Access
- 15 May 2005
- journal article
- clinical trial
- Published by American Society of Hematology
- Vol. 105 (10), 4106-4114
- https://doi.org/10.1182/blood-2003-08-2724
Abstract
A variety of patientand product-related factors influenced the outcome of 6379 transfusions given to 533 patients in the Trial to Reduce Alloimmunization to Platelets (TRAP). Responses measured were platelet increments, interval between platelet transfusions, and platelet refractoriness. Patient factors that improved platelet responses were splenectomy and increasing patient age. In contrast, at least 2 prior pregnancies, male gender, splenomegaly, bleeding, fever, infection, disseminated intravascular coagulation, increasing height and weight, lymphocytotoxic antibody positivity, an increasing number of platelet transfusions, or receiving heparin or amphotericin were associated with decreased posttransfusion platelet responses. Platelet factors that were associated with improved platelet responses were giving ABO-compatible platelets, platelets stored for 48 hours or less, and giving large doses of platelets while ultraviolet B (UV-B) or gamma irradiation decreased platelet responses. However, in alloimmunized lymphocytoxic antibody-positive patients, the immediate increment to UV-B-irradiated platelets was well maintained, whereas all other products showed substantial reductions. Refractoriness to platelet transfusions developed in 27% of the patients. Platelet refractoriness was associated with lymphocytotoxic antibody positivity, heparin administration, fever, bleeding, increasing number of platelet transfusions, increasing weight, at least 2 pregnancies, and male gender. The only factors that reduced platelet refractoriness rates were increasing the dose of platelets transfused or transfusing filtered apheresis platelets.Keywords
This publication has 26 references indexed in Scilit:
- Clinical and laboratory factors associated with platelet transfusion refractoriness: a case–control studyBritish Journal of Haematology, 1996
- Storage of apheresis platelets after gamma radiationTransfusion, 1994
- Relative Importance of Immune and Non‐Immune Causes of Platelet RefractorinessVox Sanguinis, 1994
- Effect of storage time on clinical efficacy of single‐donor platelet unitsTransfusion, 1993
- Clinical Evaluation of the Effects of Storage Time and Irradiation on Transfused PlateletsVox Sanguinis, 1991
- Viability of platelets following storage in the irradiated state. A pair‐controlled studyTransfusion, 1988
- Platelet storage for 7 days in second‐generation blood bagsTransfusion, 1986
- Longitudinal data analysis using generalized linear modelsBiometrika, 1986
- ANTIGENIC SPECIFICITY OF ANTIBODY REACTIVE IN THE ANTIGLOBULIN-AUGMENTED LYMPHOCYTOTOXICITY TESTTransplantation, 1982
- Transfusion experience with platelet concentrates stored for 24 to 72 hours at 22° CTransfusion, 1982