Transfusion Effect of Single and Random Donor Platelets in Thrombocytopenic Pediatric Patients with Hematological Malignancy at Tertiary Care Hospital

Authors

  • Nikita Surana Department of Pathology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India
  • Kavita Prakash Sawant Department of Pathology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India
  • Shreya Devidas Badhe Department of Pathology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.21276/apalm.3342

Keywords:

SDP, RDP, Corrected Count Increment, Refractoriness

Abstract

 

Background

This study was performed to assess differences between Single Donor Platelets (SDP) and Random Donor Platelets (RDP) by evaluating the platelet increment in the form of corrected count increment (CCI), platelet transfusion reaction rates, and the development of refractoriness after multiple platelet transfusions.

Material and Methods

In this two-year prospective study performed at a tertiary care hospital, dose response to platelet transfusions was studied in 68 newly diagnosed pediatric patients with hematological malignancies admitted for induction chemotherapy. The study was divided into three groups based on the type of platelet transfusion received: RDP group: Patients who exclusively received Random Donor Platelets. SDP group: Patients who exclusively received Single Donor Platelets. RDP+SDP group: Patients who received both RDP and SDP. Statistical Analyses Used: Chi-Squared test.

Results

CCI at the end of one hour (1-HR) and 24 hours (24-HR) was significantly greater in the SDP group (p-value 0.0003 and 0.0001, respectively), showing better platelet count increment after SDP transfusion. In the SDP group, the increments after the first and last transfusions were in the same range, whereas in the RDP group, the increments decreased from the first to the last transfusion. Thus, the use of SDPs postponed refractoriness. Maximum cases of the RDP group showed platelet refractoriness (50%), of which 76% were refractory due to an immune cause. The majority of acute platelet transfusion reactions were seen in the RDP group (38.98%), with the most common reaction being febrile non-hemolytic transfusion reaction.

Conclusion

The SDP group showed a better response to platelet transfusion than the other groups (RDP group and RDP+SDP group).

References

Solves Alcania P. Platelet transfusion: An update on challenges and outcomes. J Blood Med. 2020;11:19-26.

Rajadhyaksha SB, Desai PD, Navkudkar AA. Global J Transfus Med. 2019;4(2):140-147.

Delaflor-Weiss E, Mintz PD. The evaluation and management of platelet refractoriness and alloimmunization. Transfus Med Rev. 2000;14(2):180-196.

Bishop JF, Mathews JP, Yuen K, McGrath K, Wolf MM, Szer J. The definition of refractoriness to platelet transfusions. Transfus Med. 1992;2(1):35-41.

Doughty HA, Murphy MF, Metcalfe P, Rohatiner AZ, Lister TA, Waters AH. Relative importance of immune and non-immune causes of platelet refractoriness. Vox Sang. 1994;66(3):200-205.

Daly PA, Schiffer CA, Aisner J, Wiernik PH. Platelet transfusion therapy: One-hour post transfusion increments are valuable in predicting the need for HLA-matched preparations. JAMA. 1980;243(5):435-438.

Bishop JF, Mathews JP, Yuen K, McGrath K, Wolf MM, Szer J. Factors influencing 20-hour increments after platelet transfusion. Transfusion. 1991;31(5):392-396.

Slichter SJ, et al. Factors affecting post transfusion platelet increments, platelet refractoriness, and platelet transfusion intervals in thrombocytopenic patients. Blood. 2005;105(10):4106-4113.

The Trial to Reduce Alloimmunization to Platelets Study Group. Leukocyte reduction and ultraviolet B irradiation of platelets to prevent alloimmunization and refractoriness to platelet transfusions. N Engl J Med. 1997;337(26):1861-1869.

Gmur J, et al. Delayed alloimmunization using random single donor platelet transfusions: A prospective study in thrombocytopenic patients with acute leukemia. Blood. 1983;62(2):473-479.

Singh RP, Maratha N, Amphora P, Dash S. Therapeutic efficacy of different types of platelet concentrates in thrombocytopenic patients. Indian J Hematol Blood Transfus. 2008;24(2):1448-1453.

Zhang JC, Ni LH, Tu Y, Hu HX. Related donor platelet transfusion improves platelet transfusion refractoriness in hematological patients. Front Med (Lausanne). 2023;10:983644.

Comont T, et al. Platelet transfusion refractoriness in patients with acute myeloid leukemia treated by intensive chemotherapy. Leuk Res. 2017;61:62-67.

Heddle NM, et al. A randomized controlled trial comparing the frequency of acute reactions to plasma removed platelets and pre-storage WBC reduced platelets. Transfusion. 2002;42:556-566.

Ness PM, Daou L. Single donor platelets versus whole blood derived platelets: Are they the same? Ann Blood. 2020;5.

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Published

26-05-2024

How to Cite

1.
Surana N, Sawant KP, Badhe SD. Transfusion Effect of Single and Random Donor Platelets in Thrombocytopenic Pediatric Patients with Hematological Malignancy at Tertiary Care Hospital. Ann of Pathol and Lab Med [Internet]. 2024 May 26 [cited 2024 Dec. 5];11(6):A104-110. Available from: https://pacificejournals.com/journal/index.php/apalm/article/view/3342

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