The assessment of platelet function by thromboelastometry as a point-of-care test to guide Intercept-treated platelet support in hemato-oncological patients and hematopoietic stem cell transplantation recipients.
Journal
Transfusion
ISSN: 1537-2995
Titre abrégé: Transfusion
Pays: United States
ID NLM: 0417360
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
received:
02
10
2019
revised:
04
03
2020
accepted:
06
03
2020
pubmed:
23
4
2020
medline:
23
6
2021
entrez:
23
4
2020
Statut:
ppublish
Résumé
Pathogen inactivation (PI) techniques for platelet concentrates (PCs) are one of the latest innovations to improve blood safety and reduce the risk of transfusion-transmitted infections (TTIs). An impaired function and in vivo recovery of platelets as well as an increased PC demand are concerns regarding these techniques. The intent of this study was to evaluate the hemostatic effect of PCs treated with the Intercept™ System by thromboelastometry (TEM) and to assess the clinical validity of its results in comparison to post-transfusion increase (PTI) and corrected count increment (CCI). This prospective-observational study included 47 patients (m:f = 25:22; median age: 54 years [21-70]) of our Bone Marrow Transplantation unit with hemato-oncological malignancies transfused with Intercept™-treated PCs. Serial TEM measurements were performed just before and 1 hour after PC transfusion and were analyzed for their correlation with PTI and CCI as well as for clinical variables. The majority of our patients had received a hematopoietic stem cell transplantation (HSCT) (n = 41; 87%). In median 9 (1-50) PCs were transfused. Serial TEM, PTI, and CCI measurements were available for 150 transfusion episodes. The median platelet dose transfused was 2.65 × 10 Serial TEM measurements indicate the hemostatic effect of Intercept™-treated PCs. The 1-hour PTI and CCI may not appropriately reflect the in vivo function of platelets after PI PC transfusion.
Sections du résumé
BACKGROUND
Pathogen inactivation (PI) techniques for platelet concentrates (PCs) are one of the latest innovations to improve blood safety and reduce the risk of transfusion-transmitted infections (TTIs). An impaired function and in vivo recovery of platelets as well as an increased PC demand are concerns regarding these techniques. The intent of this study was to evaluate the hemostatic effect of PCs treated with the Intercept™ System by thromboelastometry (TEM) and to assess the clinical validity of its results in comparison to post-transfusion increase (PTI) and corrected count increment (CCI).
STUDY-DESIGN AND METHODS
This prospective-observational study included 47 patients (m:f = 25:22; median age: 54 years [21-70]) of our Bone Marrow Transplantation unit with hemato-oncological malignancies transfused with Intercept™-treated PCs. Serial TEM measurements were performed just before and 1 hour after PC transfusion and were analyzed for their correlation with PTI and CCI as well as for clinical variables.
RESULTS
The majority of our patients had received a hematopoietic stem cell transplantation (HSCT) (n = 41; 87%). In median 9 (1-50) PCs were transfused. Serial TEM, PTI, and CCI measurements were available for 150 transfusion episodes. The median platelet dose transfused was 2.65 × 10
CONCLUSION
Serial TEM measurements indicate the hemostatic effect of Intercept™-treated PCs. The 1-hour PTI and CCI may not appropriately reflect the in vivo function of platelets after PI PC transfusion.
Identifiants
pubmed: 32319678
doi: 10.1111/trf.15783
pmc: PMC7497158
doi:
Types de publication
Clinical Trial
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1391-1399Informations de copyright
© 2020 The Authors. Transfusion published by Wiley Periodicals, Inc. on behalf of AABB.
Références
Cochrane Database Syst Rev. 2017 Jul 30;7:CD009072
pubmed: 28756627
Br J Haematol. 2018 Sep;182(6):789-806
pubmed: 30073664
Transfus Med Hemother. 2011;38(1):19-31
pubmed: 21779203
Anaesthesia. 2016 Jun;71(6):636-47
pubmed: 26763378
Vox Sang. 2004 May;86(4):239-45
pubmed: 15144528
Transfus Med Rev. 2000 Apr;14(2):180-96
pubmed: 10782501
Ann Card Anaesth. 2014 Apr-Jun;17(2):108-10
pubmed: 24843902
Transfusion. 2016 Jul;56(7):1807-18
pubmed: 27158813
Br J Haematol. 2015 Jun;169(5):719-25
pubmed: 25817436
Haematologica. 2005 Feb;90(2):247-53
pubmed: 15710579
Hematology Am Soc Hematol Educ Program. 2003;:575-89
pubmed: 14633800
Transfus Apher Sci. 2011 Oct;45(2):175-81
pubmed: 21840762
Bone Marrow Transplant. 2006 Sep;38(5):377-84
pubmed: 16915226
Clin Appl Thromb Hemost. 2016 Mar;22(2):121-37
pubmed: 25424528
Transfusion. 2006 Apr;46(4):562-71
pubmed: 16584432
Vox Sang. 2011 Jul;101(1):35-43
pubmed: 21175668
Transfusion. 2019 Dec;59(12):3783-3793
pubmed: 31642072
Blood. 2004 Sep 1;104(5):1534-41
pubmed: 15138160
Health Technol Assess. 2015 Jul;19(58):1-228, v-vi
pubmed: 26215747
Transfusion. 1999 Jun;39(6):586-92
pubmed: 10378838
Crit Care. 2014 Feb 10;18(1):R30
pubmed: 24512650
J Cardiothorac Vasc Anesth. 2013 Dec;27(6):1181-8
pubmed: 23962459
Blood Rev. 2014 Nov;28(6):235-41
pubmed: 25192602
Ann Hematol. 2011 Dec;90(12):1457-65
pubmed: 21503644
Haematologica. 2006 Nov;91(11):1530-7
pubmed: 17043016
Blood. 2005 May 15;105(10):4106-14
pubmed: 15692069
Transfusion. 2002 Aug;42(8):975-9
pubmed: 12385406
Transfusion. 1991 Jun;31(5):392-6
pubmed: 2048176
Eur J Anaesthesiol. 2013 Jun;30(6):270-382
pubmed: 23656742
Clin Appl Thromb Hemost. 2015 Sep;21(6):558-64
pubmed: 25525046
JAMA. 2000 Jul 12;284(2):238-40
pubmed: 10889600
Anesth Analg. 1999 Feb;88(2):312-9
pubmed: 9972747
Transfusion. 2007 Jul;47(7):1134-42
pubmed: 17581147
Eur J Anaesthesiol. 2017 Jun;34(6):332-395
pubmed: 28459785
Transfusion. 2006 Mar;46(3):476-85
pubmed: 16533293
Blood. 2003 Mar 15;101(6):2426-33
pubmed: 12456508