Efficacia clinica dei concentrati piastrinici a plasma ridotto ottenuti da raccolte multicomponent: Uno studio prospettico non-randomizzato in pazienti pediatrici oncoematologici

Background and objectives. Platelet transfusions are currently used to prevent haemorrhagic events in oncohaematological patients. Recently, platelet concentrates from multicomponent collection have been introduced in several blood collection facilities. Moreover, plasma-reduced platelet concentrates (PC) have been proposed with the aim of reducing platelet transfusion-related reactions, but there is some concern about the real effectiveness of such products given the higher degree of platelet activation subsequent to the higher concentration of platelets. We performed a prospective, non randomized study to investigate the in-vivo efficacy of PC from a random donor (R-PC), plateletpheresis (A-PC) and plasma-reduced PC (PR-PC) from multicomponent collection. Material and methods. Post transfusion platelet count increase was checked by Corrected Count Increment (CCI) at +1 hour and +24 hours. Patients were monitored for the onset of side effects such as changes in arterial blood pressure, pulse rate, body temperature and for reactions such as urticaria/rash, chills, fever, etc. Platelet-specific antibody search was carried out using an immunofluorescence method (PSIFT) in patients with unsatisfactory platelet count increment. Results. Sixty-six onco-haematological patients received a total of 221 platelet transfusions and some patients received different type of PCs. Patients who were given R-PC underwent a total of 92 platelet transfusion events, while those who were given A-PC and PR-PC underwent a total of 58 and 71 platelet transfusion events, respectively. We did not find significant differences in post transfusion CCI either at +1 hour or +24 hours, in any of the three groups. Overall, patients received premedication in 116 platelet transfusion events and did not in 105 events. A total of nine moderate side effects were observed in transfused patients: six in individuals who received random donor PC and three reactions in patients who were given PR-PC from multicomponent collection. PSIFT results were negative when carried out in the nine patients who showed an unsatisfactory CCI on at least two occasions. Conclusions. Plasma-reduced PC from multicomponent collection permitted a satisfactory post transfusion platelet increment, similar to that observed in patients who were given random donor PC and plateletpheresis.