A RANDOMIZED TRIAL OF LEUKOCYTE-DEPLETED PLATELET TRANSFUSION TO MODIFY ALLOIMMUNIZATION IN PATIENTS WITH LEUKEMIA

  • 1 January 1983
    • journal article
    • research article
    • Vol. 62  (4) , 815-820
Abstract
To determine whether the use of leukocyte(WBC)-depleted platelets could modify the development of alloimmunization, 98 adult patients with acute nonlymphocytic leukemia receiving initial induction therapy were randomized to received standard pooled platelet concentrates (PC) and WBC-depleted PC. WBC depletion was produced by an additional centrifugation of pooled PC, with removal of 81% of WBC and an associated platelet loss of 27%. Lymphocytotoxic antibody (LCTAb) levels were monitored as a serologic marker of alloimmunization. Five of 25 evaluable patients receiving WBC-depleted PC developed LCTAb, compared to 13/31 receiving standard PC (P = 0.071). There was no significant difference in alloimmunization rate in the subgroup of patients who had no previous exposure to histocompatibility antigens by pregnancy or prior transfusions (4/15 alloimmunized receiving WBC depleted vs. 4/12 receiving standard PC). There was no difference in the number of patients in each group who required HLA-matched platelets during induction therapy. In view of the significant loss of platelets with WBC depletion, the expense and difficulty of providing WBC-poor RBC [red blood cells], the absence of impact on the need for HLA-matched platelets during induction and the small potential benefit from this approach, WBC-depleted platelets should not be used to prevent alloimmunization in patients with leukemia.