A big change in the CCI or PPR can occur with platelet products that have the same dose but different quality

A big change in the CCI or PPR can occur with platelet products that have the same dose but different quality. transfusions, increasing excess weight, at least 2 pregnancies, and male gender. The only factors that reduced platelet refractoriness rates were increasing the dose of platelets transfused or transfusing filtered apheresis platelets. Intro The Trial to Reduce Alloimmunization to Platelets (Capture) was a large, multi-institutional platelet transfusion trial to determine the relative performance of leukocyte reduction, ultraviolet B (UV-B) irradiation, and solitary donor apheresis platelets as methods of avoiding alloimmune platelet refractoriness.1 This trial shown that both UV-B irradiation and leukocyte reduction were equally effective in avoiding both the development of lymphocytotoxic antibodies and platelet refractoriness when it was due to alloimmunization. However, additional NFAT Inhibitor nonimmune causes of platelet refractoriness were not analyzed in earlier publications from your TRAP study. As part of this transfusion trial, individuals experienced pretransfusion and serial posttransfusion platelet counts and time-to-next-platelet-transfusion measurements recorded to evaluate transfusion reactions of platelet increment, days to next transfusion, and platelet refractoriness. Certain medical conditions of the patient at the time of the transfusion and characteristics of the transfused platelets were also monitored. Therefore, the Capture Trial database represents an opportunity to evaluate patient- and product-related characteristics that Rabbit polyclonal to APBA1 might influence posttransfusion platelet reactions in the largest data set available for a relatively homogenous patient human population. This data may also permit hypothesis generation as to why particular factors impact platelet transfusion reactions. Patients and methods Patient human population Previously untreated individuals with acute myelogenous leukemia (AML) scheduled to receive induction chemotherapy were eligible for study entry with the following exceptions: if the patient was more youthful than 15 years of age; individuals who have been to receive no or low-dose chemotherapy or corticosteroids; recipients of multiple blood transfusions for any hematopoietic disorder more than 2 weeks before study access; recipients of transfusions from more than 10 different donors between 2 weeks and 2 weeks before study access; and patients given chemotherapy or considerable radiation therapy within the past 2 years. Institutional review boards approved this study at each trial site, and educated consent was from each individual before enrollment in accordance with the Declaration of Helsinki. Preparation of platelets Individuals were randomly assigned to receive 1 of 4 types of platelet transfusions for 8 weeks after the 1st transfusion of study platelets: unmodified, pooled random donor platelet concentrates (Personal computers; control); filtered, pooled random donor platelet concentrates (F-PCs); ultraviolet B-irradiated, pooled random donor platelet concentrates (UVB-PCs); or filtered, random donor apheresis platelets (F-APs). Platelet swimming pools were usually composed of 6 devices of platelet concentrates prepared from whole blood from the platelet-rich plasma (PRP) method.2 Filtration with Pall PL-100 filters (Pall Biomedical, East Hills, New York) and UV-B irradiation at a NFAT Inhibitor dose of 1480 mJ/cm2 having a Haemonetics Irradiation Device (Haemonetics, Braintree, MA) were usually done shortly before transfusion. Apheresis platelets were collected having NFAT Inhibitor a Cobe Spectra Apheresis Machine (Cobe Laboratories, Lakewood, CO) with version 2.6 or 3.6 software. Cell counts of the platelet products were performed by automated counters after all processing was completed. Gamma () irradiation was performed with Cesium irradiators at doses of 2500 cGy to 3000 cGy. Volume reduction of platelet products was carried out by centrifugation. Platelets NFAT Inhibitor were regarded as ABO-compatible if the recipient experienced no antibodies incompatible with the donor’s red-cell type. Indications for platelet transfusions Most individuals received prophylactic platelet transfusions for platelet counts of less than or equal to 20 109/L, or at higher levels for particular medical indications; for example, active bleeding or before surgery. Response to platelet transfusions The posttransfusion platelet count is affected by the quality as well as the number of platelets transfused and also from the dilution of platelets in the NFAT Inhibitor patient’s blood volume.3 Calculations such as the corrected count increment (CCI)4 and the percent platelet recovery (PPR),5 which modify for the number of platelets transfused and the patient’s blood volume, have been presumed to give a more exact comparison of the posttransfusion platelet responses between platelet.