Prevention of HLA immunization with leukocyte-poor packed red cells and platelet concentrates obtained by filtration

Blood. 1988 Sep;72(3):964-9.

Abstract

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 (control 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 less than .05) and frequency of refractoriness to platelet transfusions (46.6% v 11.7%, P less than .05). We conclude that this filtration technique can be an efficient means to reduce the HLA immunization rate in polytransfused oncohematologic patients.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antilymphocyte Serum / analysis
  • Antilymphocyte Serum / biosynthesis
  • Cell Separation / instrumentation*
  • Cell Separation / methods
  • Erythrocyte Transfusion*
  • Female
  • Filtration
  • HLA Antigens / immunology*
  • Humans
  • Leukocytes*
  • Male
  • Middle Aged
  • Platelet Transfusion*
  • Random Allocation
  • Transfusion Reaction*

Substances

  • Antilymphocyte Serum
  • HLA Antigens