Prevention of HLA immunization with leukocyte-poor packed red cells and platelet concentrates obtained by filtration.
HLA immunization is a common complication of transfusion therapy in 30% to 60% of oncohematologic patients. Evidence shows that leukocytes present in cellular blood products are the main component involved in the occurrence of HLA immunization, and several studies showed that leukocyte-poor blood products are less able to induce it. However, leukocyte-poor platelet concentrates obtained by conventional techniques, ie, centrifugation, frequently have a high level of remaining leukocytes. Cotton wool filter Imugard IG 500 can be used to obtain leukocyte-poor cellular blood products. The technique is easy to perform, even in an emergency, and can be used with either packed RBCs or platelet concentrates. Means of 97%, 92%, and 76% elimination of leukocytes are obtained for packed RBCs, pooled standard platelet concentrates, and single-donor platelet concentrates, respectively. Patients were randomized to receive either standard (control group) or filtered (leukocyte-poor group) blood products. Of 112 randomized patients, 69 were evaluable, 35 in the control group and 34 in the leukocyte-poor group. Both groups are comparable according to age, diagnosis, sex ratio, previous transfusions, and pregnancies. There is a significant difference in regard to the HLA immunization rate (31.4% in the control v 11.7% in the leukocyte-poor group, P less than .05) and frequency of refractoriness to platelet transfusions (46.6% v 11.7%, P less than .05). We conclude that this filtration technique can be an efficient means to reduce the HLA immunization rate in polytransfused oncohematologic patients.
Blood Bank, Paris Hotel-Dieu, France.
G
G
Andreu
J
J
Dewailly
C
C
Leberre
M C
MC
Quarre
M L
ML
Bidet
R
R
Tardivel
L
L
Devers
Y
Y
Lam
E
E
Soreau
C
C
Boccaccio
D000293:Adolescent; D000328:Adult; D000368:Aged; D000961:Antilymphocyte Serum / Q000032:analysis / Q000096:biosynthesis; D002469:Cell Separation / Q000295:instrumentation* / Q000379:methods; D017707:Erythrocyte Transfusion; D005260:Female; D005374:Filtration; D006680:HLA Antigens / Q000276:immunology*; D006801:Humans; D007962:Leukocytes; D008297:Male; D008875:Middle Aged; D017713:Platelet Transfusion; D011897:Random Allocation; D065227:Transfusion Reaction
D000961:Antilymphocyte Serum; D006680:HLA Antigens