A prospective, randomized study of the use of platelet concentrates irradiated with ultraviolet-B light in patients with hematologic malignancy. Transfusion 1996 Apr;36(4):296-302
Date
04/01/1996Pubmed ID
8623127DOI
10.1046/j.1537-2995.1996.36496226140.xScopus ID
2-s2.0-9244256815 (requires institutional sign-in at Scopus site) 26 CitationsAbstract
BACKGROUND: Irradiation of platelet concentrates (PCs) with ultraviolet-B (UVB) light inactivates the contaminating white cells and might be an alternative to filtration for the prevention of alloimmunization to HLA antigens and subsequent refractoriness to further platelet transfusions in multiply transfused patients with bone marrow failure.
STUDY DESIGN AND METHODS: Patients with hematologic malignancy, mainly acute myeloid leukemia, were prospectively assigned in a random manner to receive either UVB-irradiated or control, nonirradiated PCs. All patients were given red cells that were white cell reduced by filtration. Transfusion efficacy and alloimmunization were assessed by means of corrected count increments, requirement for red cells and PCs, and measurement of lymphocyte-reactive antibodies.
RESULTS: UVB-irradiated PCs had a clinical efficacy similar to controls as judged by corrected count increments at 1 to 6 and 12 to 24 hours and by the median requirement for red cell and platelet transfusions. Alloimmunization determined by measurements of lymphocyte-reactive antibodies using both conventional and antiglobulin-augmented lymphocytotoxicity techniques was not abolished in recipients of UVB-irradiated PCs (4/30, 13%) but was less than that in controls (5/20, 25%; p = NS). The mean number of platelet transfusion episodes prior to the occurrence of alloimmunization was greater in the control group (27 vs. 10; p = 0.017).
CONCLUSION: In this trial, UVB irradiation did not diminish the clinical efficacy of platelet transfusions. There was a small but nonsignificant reduction alloimmunization, but no difference in refractoriness of the two groups was observed. Larger prospective randomized studies are required to confirm these findings and to compare UVB irradiation with white cell reduction.
Author List
Blundell EL, Pamphilon DH, Fraser ID, Menitove JE, Greenwalt TJ, Snyder EL, Repucci AJ, Hedberg SL, Anderson JK, Buchholz DH, Kagen LR, Aster RHMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Aged, 80 and over
Blood Platelets
Child
Child, Preschool
Female
Humans
Immunization
Leukemia, Myeloid, Acute
Lymphoma
Male
Middle Aged
Platelet Transfusion
Prospective Studies
Ultraviolet Rays