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Clinical factors influencing the efficacy of pooled platelet transfusions
JF Bishop, K McGrath, MM Wolf, JP Matthews, T De Luise, R Holdsworth, K Yuen, M Veale, MG Whiteside and IA Cooper
Alfred Hospital, Peter MacCallum Cancer Institute, Melbourne, Victoria,
Australia.
To determine the relative importance of clinical factors on the efficacy of
platelet transfusions, 941 pooled platelet transfusions from HLA-unmatched
donors were studied prospectively in 133 patients with bone marrow failure.
Multiple linear regression analyses identified the major factors
influencing one-hour-corrected increments (CI) as prior splenectomy, bone
marrow transplantation, disseminated intravascular coagulation, concurrent
intravenous amphotericin B, splenomegaly, and HLA antibody grade. The
relative impact of these factors on CI has been quantitated by using a
formula developed from these data. A linear relationship was demonstrated
between increasing percentage of HLA antibody grade and decreasing CI. A
number of other factors were less important in the linear regression model
than the aforementioned major factors. These included platelet-specific
antibodies, concurrent antibacterial antibiotics, clinical bleeding grade,
and temperature. Factors that did not influence CI included the number of
prior platelet transfusions, prior granulocyte transfusions, prior red cell
transfusions, infection, age, blood group, diagnosis, sex, pretransfusion
platelet count, prior pregnancies, and concurrent antineoplastic drugs.
This study identified major clinical factors that significantly influenced
CI and were major causes of refractoriness to pooled platelet transfusions.
Volume 71,
Issue 2,
pp. 383-387,
02/01/1988
Copyright © 1988 by The American Society of Hematology
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