Prevention of HLA Immunization With Leukocyte-Poor Packed Red Cells and Platelet Concentrates Obtained by Filtration

• Published in: Blood 1988-09, Vol.72 (3), p.964-969
• Main Authors: Andreu, G., Dewailly, J., Leberre, C., Quarre, M.C., Bidet, M.L., Tardivel, R., Devers, L., Lam, Y., Soreau, E., Boccaccio, C., Piard, N., Bidet, J.M., Genetet, B., Fauchet, R.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Antilymphocyte Serum - analysis; Antilymphocyte Serum - biosynthesis; Biological and medical sciences; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis; Cell Separation - instrumentation; Cell Separation - methods; Erythrocyte Transfusion; Female; Filtration; HLA Antigens - immunology; Humans; Leukocytes; Male; Medical sciences; Middle Aged; Platelet Transfusion; Random Allocation; Transfusion Reaction; Transfusions. Complications. Transfusion reactions. Cell and gene therapy
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood.V72.3.964.964

HLA immunization is a common complication of transfusion therapy in 30% to 60% of oncohematologic patients. Evidence shows that leukocytes present in cellular blood products are the main component involved in the occurrence of HLA immunization, and several studies showed that leukocyte-poor blood products are less able to induce it. However, leukocyte-poor platelet concentrates obtained by conventional techniques, ie, centrifugation, frequently have a high level of remaining leukocytes. Cotton wool filter Imugard IG 500 can be used to obtain leukocyte-poor cellular blood products. The technique is easy to perform, even in an emergency, and can be used with either packed RBCs or platelet concentrates. Means of 97%, 92%, and 76% elimination of leukocytes are obtained for packed RBCs, pooled standard platelet concentrates, and single-donor platelet concentrates, respectively. Patients were randomized to receive either standard (con-trol group) or filtered (leukocyte-poor group) blood products. Of 112 randomized patients, 69 were evaluable, 35 in the control group and 34 in the leukocyte-poor group. Both groups are comparable according to age, diagnosis, sex ratio, previous transfusions, and pregnancies. There is a significant difference in regard to the HLA immunization rate (31.4% in the control v 11.7% in the leukocyte-poor group, P < .05) and frequency of refractoriness to platelet transfusions (46.6% v 11.7%, P < .05). We conclude that this filtration technique can be an efficient means to reduce the HLA immunization rate in polytransfused oncohemato-logic patients.1988 by Grune & Stratton, Inc. 0006-4971/88/7203-0023$3.00/0