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Blood, 1 September 2001, Vol. 98, No. 5, pp. 1346-1351
CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS
Prophylactic platelet transfusions from healthy apheresis
platelet donors undergoing treatment with thrombopoietin
Lawrence T. Goodnough,
David J. Kuter,
Jeffrey McCullough,
Sherrill J. Slichter,
John DiPersio,
John Romo,
Randolph Peterson,
Kenneth J. Smith,
Thomas Raife,
Dianne Tomita, and
Susan Armstrong
From the Departments of Medicine and Pathology,
Washington University, St Louis, MO; Departments of Medicine and
Pathology, Massachusetts General Hospital, Boston, MA; Department of
Laboratory Medicine and Pathology, University of Minnesota,
Minneapolis; Puget Sound Blood Center and University of Washington
School of Medicine, Seattle; Department of Medicine, Emory University
School of Medicine, Atlanta, GA; Blood Center of Southeastern
Wisconsin, Milwaukee; and Amgen, Thousand Oaks, CA.
Many patients receiving dose-intensive chemotherapy acquire
thrombocytopenia and need platelet transfusions. A study was conducted to determine whether platelets harvested from healthy donors treated with thrombopoietin could provide larger increases in platelet counts
and thereby delay time to next platelet transfusion compared to
routinely available platelets given to thrombocytopenic patients. Community platelet donors received either 1 or 3 µg/kg
pegylated recombinant human megakaryocyte growth and
development factor (PEG-rHuMGDF) or placebo and then donated platelets
10 to 15 days later. One hundred sixty-six of these platelet
concentrates were then transfused to 120 patients with platelets counts
25 × 109/L or lower. Pretransfusion platelet counts
(11 × 109/L) were similar for recipients of
placebo-derived and PEG-rHuMGDF-derived platelets. Early after
transfusion, the median platelet count increment was higher in patients
receiving PEG-rHuMGDF-derived platelets: 19 (range,
 12-66) × 109/L, 41 (range,
5-133) × 109/L, and 82 (range,
4-188) × 109/L for placebo-, 1-µg/kg-, and
3-µ/kg-derived platelets, respectively. This difference was
maintained 18 to 24 hours after transfusion. Transfusion-free intervals
were 1.72, 2.64, and 3.80 days for the recipients of the placebo-,
1-µg/kg-, and 3-µ/kg-derived platelets, respectively. The rate of
transfusion-related adverse events was not different in
recipients of placebo-derived and PEG-rHuMGDF-derived platelets.
Therefore, when transfused into patients with thrombocytopenia, platelets collected from healthy donors undergoing thrombopoietin therapy were safe and resulted in significantly greater platelet count
increments and longer transfusion-free intervals than platelets obtained from donors treated with placebo.
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