title: [Prevention of platelet transfusion refractoriness and HLA alloimmunization by leukocyte filtered platelet transfusion: a meta analysis].
abstract: OBJECTIVE
  To compare and assess the effectiveness of leukocyte-filtered platelet and standard platelet concentrates transfusion in preventing platelet transfusion refractoriness (PTR) and human leukocyte antigen (HLA)-alloimmunization.
  
  
  METHODS
  Randomized controlled trials (RCTs) or quasi-RCTs comparing leukocyte-filtered platelet with standard platelet concentrates transfusion (up to December 31, 2009) were searched and identified from Medline, EMBASE, The Cochrane Library, and CBM. A meta-analysis was conducted with Cochrane Collaboration's RevMan 5. 0.
  
  
  RESULTS
  The search identified 558 citations in total, in which 7 articles in English were finally included in the meta-analysis. The analysis showed that compared with standard platelet concentrates transfusion, leukocyte-filtered platelet transfusion significantly decreased PTR [ RR = 0. 59, 95% CI (0. 42, 0. 82) , P = 0. 002 ] and HLA-alloimmunization [ RR = 0. 49,95% CI (0. 33, 0. 74) , P =0. 0006]. Subgroup analysis showed that HLA-alloimmunization was significantly reduced by leukocyte-filtered platelet transfusion among the patients with acute myelocytic leukemia [ RR =0.42, 95% CI (0.32, 0.56), P <0. 00001], while no significant difference was detected in patients with acute lymphoblastic leukemia because of the limited sample size [ RR = 0. 50, 95% CI (0. 10, 2.41) , P =0. 39].
  
  
  CONCLUSIONS
  The current evidence shows that leukocyte-filtered platelet transfusion can prevent PTR and HLA-alloimmunization more effectively than standard platelet transfusion. Well-designed large-scale RCTs are still needed to further confirm this finding.
authors: West China Hospital, Sichuan University, Chengdu, China.
authors: Qiang
authors: Q
authors: Yuan
authors: Xue
authors: X
authors: Chen
authors: Lan
authors: L
authors: Cheng
authors: Chang-hua
authors: CH
authors: Zhou
authors: Xue-mei
authors: XM
authors: Fu
authors: You-ping
authors: YP
authors: Li
authors: Nai-hong
authors: NH
authors: Wang
authors: Li
authors: L
authors: Wang
mesh_terms: D005374:Filtration; D006680:HLA Antigens / Q000276:immunology; D006801:Humans; D007962:Leukocytes / Q000276:immunology; D017713:Platelet Transfusion / Q000379:methods*; D016032:Randomized Controlled Trials as Topic
chemical_list: D006680:HLA Antigens