Comparative assessment of prophylactic transfusions of platelet concentrates obtained by the PRP or buffy-coat methods, in patients undergoing allogeneic hematopoietic stem cell transplantation. Issue 9 (21st October 2018)

• Record Type: Journal Article
• Authors: Fernández-Muñoz, Hermógenes; Plaza, Eva M.; Rivera-Caravaca, José Miguel; Candela, María José; Romera, Marta; De Arriba, Felipe; Lozano, María L.; Vicente, Vicente; Heras, Inmaculada; Castilla-Llorente, Cristina; Rivera, José
• Is Part Of: Hematology. Volume 23:Issue 9(2018)
• Page Start: 712
• Page End: 718
• Publication Date: 2018-10-21
• Subjects: Buffy-coat -- platelet-rich plasma -- correct count increment -- platelet transfusion -- allogeneic hematopoietic cell transplant -- whole blood derived platelets -- platelet concentrates -- bleeding outcomes; Blood -- Diseases -- Periodicals; Hematology -- Periodicals; Blood -- Transfusion -- Periodicals; 616.15005
• DOI: 10.1080/10245332.2018.1455434
• Languages: English
• ISSNs: 1024-5332

Abstract

ABSTRACT: Objectives: Whole blood-derived platelet concentrates can be obtained by the platelet-rich plasma (PRP-PCs) or the buffy-coat (BC-PCs) method. Few studies have shown that BC-PCs display lower in vitro platelet activation, but scarce information exists regarding transfusion efficacy. We have performed a retrospective study assessing platelet transfusion in patients undergoing allogeneic hematopoietic cell transplantation (AHCT) in our clinic, before and after the implementation of BC-PCs. Methods: We reviewed clinical records corresponding to 70 PRP-PCs and 86 BC-PCs prophylactic transfusions, which were performed to 55 AHCT patients. Transfusion efficacy was assessed by the 24-h post-transfusion corrected count increment (24-h CCI) and bleeding events. Clinical factors affecting transfusion outcome were also investigated. Results: Clinical characteristics and the total number of platelet transfusions were similar among groups. Mean donor exposure was 5.8 and 5.0 in each single PRP-PCs and BC-PCs transfusion, respectively ( p < 0.01). The 24-h CCI was significantly higher in patients transfused with BC-PCs than in those receiving PRP-PCs (8.3[2.7–13.4] vs. 4.7[1.3–8.1]; p < 0.01). Independent predictors of poor platelet transfusion response included diagnosis other than acute leukemia (HR 8.30; 95% CI 1.96–35.22; p = 0.004), splenomegaly (HR 8.75; 95% CI 2.77–27.60; p < 0.001), graft versus host disease prophylaxis different from cyclosporine A and methotrexate (HR 3.96; 95% CI 1.55–10.14; p = 0.004) and PRP-PCs transfusion (HR 4.54; 95% CI 1.72–12.01; p = 0.002). There were no differences between both groups regarding the bleeding events. Conclusion : In the AHCT setting, we hypothesize that BC-PCs transfusion, when compared to PRP-PCs, results in higher CCI and reduced donor exposure, but provides no significant benefit regarding bleeding outcome.