Leukocyte-reduced transfusions of ABO-identical platelets and clinical outcome in autologous bone marrow transplantation for lymphoma.
In observational studies, use of ABO-identical platelets and leukocyte-reduced blood components have been associated with prolonged survival and reduced morbidity in acute leukemia. We present an analysis of the clinical results of instituting a policy of ABO-identical, leukoreduced transfusions in adult patients with lymphoma undergoing autologous bone marrow transplantation. Consecutive patients with Hodgkin's disease or non-Hodgkin's lymphoma were treated with a BEAC conditioning regimen. The use of ABO-identical platelets and leukoreduction of blood components was associated with reductions in mean number of days with fever > or = 38.5 degrees C (17 vs 10), number of days of antibiotics (34 vs 22) and numbers of days until recovery of neutrophil count > or = 500 x 10(6)/l (26 vs 18). Use of leukoreduced transfusions was the only statistically significant treatment factor predicting more rapid neutrophil engraftment. No significant difference in event-free or overall survival was observed. The differences in morbidity were not explained by variations in supportive care such as use of hematopoietic growth factors, use of peripheral blood stem cells or by any measures of pretransplant disease extent or severity. While conclusions based on cohort studies must be viewed conservatively, these data are consonant with observations from previous animal models and clinical studies. ABO-identical platelet transfusions and leuko-reduction are associated with reduced morbidity in patients undergoing autologous bone marrow transplantation for lymphoma.
Heal
J M
JM
Department of Pathology, University of Rochester Medical Center, NY 14642.
Blumberg
N
N
Kirkley
S A
SA
DiPersio
J F
JF
Rapoport
A P
AP
Rowe
J M
JM
D000017:ABO Blood-Group System; D000328:Adult; D016026:Bone Marrow Transplantation / Q000379:methods*; D005069:Evaluation Studies as Topic; D005260:Female; D006648:Histocompatibility; D006801:Humans; D007962:Leukocytes / Q000166:cytology; D008223:Lymphoma / Q000628:therapy*; D008297:Male; D017713:Platelet Transfusion / Q000379:methods*; D016019:Survival Analysis; D014182:Transplantation, Autologous
D000017:ABO Blood-Group System