Clinical experience with transfusion of leukocyte-poor platelet concentrates prepared by filtration with prostacyclin

Abstract Repeated transfusions with platelets from randomly selected donors lead to HLA alloimmunization in about 50% of patients due to lymphocyte contamination of platelet concentrates. Attempts to remove the leukocytes from the platelet concentrates by additional centrifugation steps led to substantial loss of platelets. We report a new procedure for removal of almost all leukocytes with excellent platelet recoveries. Single donor concentrates are treated with 50 ng/mL prostacyclin to inactivate the platelets transiently. The concentrates are then passed through a cellulose-acetate filter to remove the leukocytes. In 30 concentrates this treatment reduced the contamination by leukocytes to less than 0.1 million per concentrate with a platelet recovery of 89% +/- 1% (mean +/- SEM). Thirty filtered platelet concentrates transfused to ten thrombocytopenic patients within one hour after filtration were well tolerated and led to corrected count increments of (22.0 +/- 1.1) X 10(6)/mL blood after one hour and normal survival thereafter. In four of five patients these concentrates reduced the bleeding time. We conclude that transient inactivation of platelets by prostacyclin enables optimal removal of leukocytes and may help to reduce alloimmunization during frequent transfusions with platelet concentrates.

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Clinical experience with transfusion of leukocyte-poor platelet concentrates prepared by filtration with prostacyclin

Blood ◽

10.1182/blood.v70.1.243.bloodjournal701243 ◽

1987 ◽

Vol 70 (1) ◽

pp. 243-246

Author(s):

HC van Prooijen ◽

TI Riemens ◽

JW Akkerman

Keyword(s):

Cellulose Acetate ◽

Clinical Experience ◽

Bleeding Time ◽

Platelet Concentrates ◽

Platelet Recovery ◽

Substantial Loss ◽

Single Donor ◽

Almost All ◽

Cellulose Acetate Filter

Repeated transfusions with platelets from randomly selected donors lead to HLA alloimmunization in about 50% of patients due to lymphocyte contamination of platelet concentrates. Attempts to remove the leukocytes from the platelet concentrates by additional centrifugation steps led to substantial loss of platelets. We report a new procedure for removal of almost all leukocytes with excellent platelet recoveries. Single donor concentrates are treated with 50 ng/mL prostacyclin to inactivate the platelets transiently. The concentrates are then passed through a cellulose-acetate filter to remove the leukocytes. In 30 concentrates this treatment reduced the contamination by leukocytes to less than 0.1 million per concentrate with a platelet recovery of 89% +/- 1% (mean +/- SEM). Thirty filtered platelet concentrates transfused to ten thrombocytopenic patients within one hour after filtration were well tolerated and led to corrected count increments of (22.0 +/- 1.1) X 10(6)/mL blood after one hour and normal survival thereafter. In four of five patients these concentrates reduced the bleeding time. We conclude that transient inactivation of platelets by prostacyclin enables optimal removal of leukocytes and may help to reduce alloimmunization during frequent transfusions with platelet concentrates.

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CLINICAL EXPERIENCE WITH TRANSFUSION OF LEUKOCYTE-POOR PLATELET CONCENTRATES PREPARED BY FILTRATION WITH PROSTACYCLIN

10.1055/s-0038-1644688 ◽

1987 ◽

Author(s):

M Van Marwijk Kooy ◽

H c van Prooijen ◽

T I Reimens ◽

J W N Akkerman

Keyword(s):

Side Effects ◽

Cellulose Acetate ◽

Clinical Experience ◽

Bleeding Time ◽

Platelet Concentrates ◽

Platelet Recovery ◽

Single Donor ◽

The Hague ◽

Almost All ◽

Cellulose Acetate Filter

Repeated transfusions with platelets from randomly selected donors lead to HLA alloimmunization in about 50% of thepatients. This is caused by lymphocytes that contaminate the platelet concentrates. Attempts to remove the leukocytes from the platelet concentrates by additional centrifugation steps lead to substantial loss of platelets.We report here a new procedure for removal of almost all leukocytes with excellent platelet recoveries. Single donor concentrates are treated with 50 ng/ml prostacyclin in order to inactivate the platelets transiently. The concentrates are then passed through a cellulose acetate filter to remove the leukocytes. In 30 fresh concentrates this treatment reduced the contamination by leukocytes to less than 0.1 million per concentrate with a platelet recovery of 89± 1% (mean ±SEM). In concentrates stored for 3 days the contamination was reduced to about 5 million per concentrate. Thirty filtered platelet concentrates, obained from single donors by platelet apheresis using a Haemonetics U 50, were transfused to ten thrombocytopenic patients within 1 hour after filtration and were well tolerated. No signs of hypotension or other side effects were observed. The transfusions led to corrected count increments of (22.0±1.1) x 10 per ml blood after one hour and normal survival thereafter. In four out of five patients these concentrates reduced the bleeding time.We conclude that transient inactivation of platelets by prostacyclin enables optimal removal of leukocytes and may help to reduce alloimmunization during frequent transfusions with platelet concentrates.Supported by the Praeventionfund (grant 28953), The Hague.

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THE LOCATION OF THE XANTHATE GROUPS IN PARTLY SUBSTITUTED CELLULOSE XANTHATES

Canadian Journal of Chemistry ◽

10.1139/v57-200 ◽

1957 ◽

Vol 35 (12) ◽

pp. 1522-1533 ◽

Cited By ~ 6

Author(s):

E. P. Swan ◽

C. B. Purves

Keyword(s):

Cellulose Acetate ◽

Chlorine Dioxide ◽

Methyl Esters ◽

Lead Tetraacetate ◽

Degree Of Substitution ◽

Hydroxyl Groups ◽

Primary Position ◽

Standard Methods ◽

The Third ◽

Almost All

Cellulose sodium xanthates of degree of substitution (D.S.) 0.4 to 0.66 were methylated to xanthate S-methyl esters which were then acetylated completely, the final xanthate D.S. remaining close to the original value. Dexanthation with aqueous chlorine dioxide near pH 4.5 and −5° removed almost all of the S-methyl xanthate groups, but the loss of a few acetyl groups from, and the retention of 1 to 2% of sulphur in, the resulting cellulose acetate could not be avoided. The original xanthate groups were presumably represented in this acetate as unsubstituted hydroxyl groups, and these were located by standard methods involving tosylation–iodination, tritylation, and oxidations with lead tetraacetate. Xanthate groups appeared to occupy the third and sixth, but not the second, position in the cellulose, and 53 to 61% of the substituent was in the sixth or primary position; one sample of viscose was "ripened" before the cellulose sodium xanthate was isolated, and the value was 81%. The results were of a preliminary nature, because severe technical difficulties reduced their reliability.

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Soluble CD40L and CD62P levels differ in single‐donor apheresis platelet concentrates and buffy coat–derived pooled platelet concentrates

Transfusion ◽

10.1111/trf.14974 ◽

2018 ◽

Vol 59 (1) ◽

pp. 16-20 ◽

Cited By ~ 2

Author(s):

Caroline Sut ◽

Sofiane Tariket ◽

Chaker Aloui ◽

Charles‐Antoine Arthaud ◽

Marie‐Ange Eyraud ◽

...

Keyword(s):

Buffy Coat ◽

Platelet Concentrates ◽

Single Donor ◽

Soluble Cd40l

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Delayed alloimmunization using random single donor platelet transfusions: a prospective study in thrombocytopenic patients with acute leukemia

Blood ◽

10.1182/blood.v62.2.473.473 ◽

1983 ◽

Vol 62 (2) ◽

pp. 473-479 ◽

Cited By ~ 95

Author(s):

J Gmur ◽

A von Felten ◽

B Osterwalder ◽

H Honegger ◽

A Hormann ◽

...

Keyword(s):

Acute Leukemia ◽

Prospective Study ◽

Randomized Study ◽

Platelet Concentrates ◽

Single Donor ◽

Time Period ◽

A Prospective Study ◽

Platelet Transfusions

Abstract A randomized study was performed in 54 thrombocytopenic patients with acute leukemia. Alloimmunization of recipients of random multiple-donor platelet concentrates (MD group) was compared to that of patients receiving random single-donor platelets (SD group). In the SD patients, formation of alloantibodies (mostly anti-HLA) occurred less frequently (p less than 0.002), after a longer time period (p less than 0.002), and after a higher number of transfusions (p less than 0.005) as compared to MD patients. SD patients also became refractory to random platelets less frequently (p less than 0.005), after a longer time period, and after a higher number of transfusions (p less than 0.02). In SD patients, the increments after the first and the last transfusion were in the same range, whereas in MD patients, the 1-hr (p less than 0.001) and the 24-hr (p less than 0.025) increments decreased from the first to the last transfusion. Thus, the use of random SD platelet transfusions postponed alloimmunization.

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Evaluation of the in vitro Function of Platelet Concentrates from Pooled Buffy Coats or Apheresis

Transfusion Medicine and Hemotherapy ◽

10.1159/000504917 ◽

2020 ◽

Vol 47 (4) ◽

pp. 314-325

Author(s):

Sarah Anna Fiedler ◽

Klaus Boller ◽

Ann-Christine Junker ◽

Christel Kamp ◽

Anneliese Hilger ◽

...

Keyword(s):

Shear Stress ◽

Annexin V ◽

Storage Conditions ◽

Platelet Concentrate ◽

Platelet Concentrates ◽

Stability Parameters ◽

Single Donor ◽

Transmission Electron ◽

Soluble Cd40l

Background: Platelet concentrates play an important role in transfusion medicine. Their short lifespan and lack of robustness require efforts to ensure adequate product quality. In this study, we compared the in vitro quality of the main concentrate types, pooled platelet concentrate (PPC) from whole blood donations, and platelet concentrate from single-donor apheresis (APC). Methods: Twenty PPCs and 20 APCs prepared in plasma were analyzed on days 2, 4, and 7 of storage. Variables related to metabolism, degranulation, platelet aggregation, P-selectin expression, and annexin V binding were analyzed. Morphology was assessed by transmission electron microscopy of ultrathin sections. A microfluidic device was applied to test the effects of shear stress on platelet function. Results: The metabolic parameters indicated stable storage conditions throughout the 7-day period. The resting discoid form was the prevailing morphology on days 2 and 4 in the PPCs and APCs. Chemokine release and receptor shedding of soluble P-selectin and soluble CD40L equally increased in PPCs and APCs. Aggregation responses to ADP and collagen were heterogeneous, with marked losses in collagen responsiveness on day 4 in individual concentrates. Baseline expression of P-selectin in PPCs and APCs was low, and inducibility of P-selectin was well preserved until day 4. Under shear stress, equal adhesiveness and stability were found with platelets from PPCs and APCs. Conclusions: Platelets from PPCs and APCs showed similar in vitro function and stability parameters. However, platelet concentrates presented a high variability and individual concentrates an impaired functional capability. Identifying the factors contributing to this would help increase product reliability.

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Should Intermittent Androgen Deprivation Be Used in Routine Clinical Practice?

Journal of Clinical Oncology ◽

10.1200/jco.2005.03.2557 ◽

2005 ◽

Vol 23 (32) ◽

pp. 8212-8218 ◽

Cited By ~ 44

Author(s):

Manish S. Bhandari ◽

Juanita Crook ◽

Maha Hussain

Keyword(s):

Clinical Experience ◽

Specific Antigen ◽

High Response Rate ◽

Androgen Deprivation ◽

Phase Iii ◽

Androgen Independence ◽

Refractory State ◽

Impact On Survival ◽

Hormone Refractory ◽

Almost All

For several decades, androgen deprivation (AD) has been the mainstay for treating metastatic prostate cancer. AD can be attained by a variety of means; however, irrespective of modality and a gratifying initial high response rate, almost all patients advance to a state of androgen independence and ultimately a hormone-refractory state. Improved understanding of the biology and mechanisms of progression to androgen independence coupled with promising preclinical data have led to investigating intermittent AD (IAD) as a way of improving disease control while maintaining quality of life. Preliminary published clinical experience, mostly from uncontrolled trials, suggests the feasibility of this approach. Two ongoing cooperative-group phase III trials are evaluating the survival impact of IAD both in patients with metastatic disease and in those with prostate-specific antigen failure post–radiation therapy. There are several unanswered questions regarding this approach, and until more definitive data regarding its safety and impact on survival are available, IAD should be considered experimental. In this review, we detail the background and preclinical scientific rational for investigating IAD, and we review published clinical experience and describe the ongoing phase III clinical trials. We also discuss special considerations for using IAD outside the context of a clinical trial.

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