Platelet quality measured with dynamic light scattering correlates with transfusion outcome in hematologic malignancies.
BACKGROUND
A clinically meaningful test for platelet (PLT) quality could improve the transfusion management of patients. The aim of this pilot study was to determine whether a new measure of PLT quality and function based on dynamic light scattering (DLS) correlates with transfusion outcome.


METHODS
For a total of 160 transfusions, the pretransfusion, 1 hour posttransfusion, and 24-hour posttransfusion PLT counts were routinely measured in 49 patients (31 male, 18 female; age 46 +/- 15 years) with hematologic malignancies. The corrected count increments (CCIs) at 1 hour (PLT recovery) and 24 hours (PLT survival) were calculated and used as the transfusion outcome measures. The ThromboLUX score (LightIntegra Technology, Inc., Vancouver, BC, Canada; range, 0-40; cutoff, 12) and the PLT morphology score of the PLT concentrates were determined and compared to transfusion outcome.


RESULTS
The CCIs and ThromboLUX scores were normally distributed and showed a strong correlation (n = 96, in the mixed regression model the adjusted coefficient is R = 0.6292, p < 0.0001), while other variables such as product type, age, and microscopic PLT morphology score were not correlated with transfusion outcome (p > 0.05). Importantly, 12 of 96 transfusions with poor PLT quality were clinically ineffective, that is, did not adequately increase the PLT counts in the recipients. One patient died after receiving three consecutive ineffective PLT transfusions with a low ThromboLUX score.


CONCLUSIONS
In this pilot study, the ThromboLUX score strongly correlated with transfusion outcome (PLT recovery and survival) independent of clinical and product issues.
Maurer-Spurej
Elisabeth
E
Canadian Blood Services, Ottawa, Ontario, Canada. emaurer@interchange.ubc.ca
Labrie
Audrey
A
Pittendreigh
Cheryl
C
Chipperfield
Kate
K
Smith
Clayton
C
Heddle
Nancy
N
Liu
Yang
Y
Yi
Qi-Long
QL
Barnett
Michael
M
D000328:Adult; D001792:Blood Platelets / Q000166:cytology* / Q000378:metabolism*; D005260:Female; D019337:Hematologic Neoplasms / Q000628:therapy*; D006801:Humans; D008027:Light; D008297:Male; D008875:Middle Aged; D017713:Platelet Transfusion / Q000379:methods*; D012542:Scattering, Radiation; D016896:Treatment Outcome