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Prepublished online as a Blood First Edition Paper on September 4, 2003; DOI 10.1182/blood-2003-03-0940. This Article Full Text (PDF) All Versions of this Article: 2003-03-0940v1 103/1/333    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Seftel, M. D Articles by Hogge, D. E Search for Related Content PubMed PubMed Citation Articles by Seftel, M. D Articles by Hogge, D. E Social Bookmarking                   What's this? Submitted March 28, 2003 Accepted August 28, 2003 Universal pre-storage leukoreduction in Canada decreases platelet alloimmunization and refractoriness Matthew D Seftel, Gershon H Growe, Tanya Petraszko, W Barrett Benny, Alan Le, Chao-Yong Lee, John J Spinelli, Heather J Sutherland, Peter Tsang, and Donna E Hogge* Leukemia/BMT Program, British Columbia Cancer Agency, Vancouver, BC, Canada; Division of Hematology, Vancouver General Hospital, Vancouver, BC, Canada; Division of Hematology, University of British Columbia, Vancouver, BC, Canada Division of Hematopathology, Vancouver General Hospital, Vancouver, BC, Canada; Division of Hematopathology, University of British Columbia, Vancouver, BC, Canada * Corresponding author; email: dhogge{at}bccancer.bc.ca. Randomized controlled trials (RCT) have shown a reduction in platelet alloimmunization and refractoriness in patients with acute leukemia (AL) with the use of post-storage leukoreduction of blood products. Universal pre-storage leukoreduction (ULR) of red cell and platelet products has been performed in Canada since August 1999. We conducted a retrospective analysis of 13,902 platelet transfusions in 617 patients undergoing chemotherapy (CT) for AL or stem cell transplantation (SCT) pre (n=315) and post (n=302) the introduction of ULR. Alloimmunization was significantly reduced (19 % to 7%, p< 0.001) in the post-ULR group. Alloimmune platelet refractoriness was similarly reduced (14% to 4%, p<0.001). Fewer patients in the post-ULR group received HLA-matched platelet (14% vs. 5%, p<0.001). Alloimmunization and alloimmune refractoriness in the 318 patients who were previously pregnant and/or transfused was also reduced post ULR (p=0.023 and p= 0.005 respectively). In a Cox regression model, the three independent factors that predicted for alloimmune refractoriness were non-leukoreduced blood products (RR [95% C.I] = 2.2 [1.2-4.3]), a history of pregnancy and/or transfusion (RR=2.3 [1.3-4.2]) and receipt of 13 platelet transfusions (RR= 6.0 [2.4-15.3]). In conclusion, ULR reduces alloimmunization, refractoriness, and requirements for HLA-matched platelets when applied as routine transfusion practice to patients receiving CT or SCT. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: T. R. Klumpp and D. L. Siegel Transfusion medicine ASH Self-Assessment Program, January 1, 2007; 2007(1): 408 - 443. [Full Text] [PDF]

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