Factors affecting posttransfusion platelet increments, platelet refractoriness, and platelet transfusion intervals in thrombocytopenic patients

Sherrill J. Slichter, Kathryn Davis, Helen Enright, Hayden Braine, Terry Gernsheimer, Kuo Jang Kao, Thomas Kickler, Edward Lee, Janice McFarland, Jeffrey McCullough, Glenn Rodey, Charles A. Schiffer, Robert Woodson

Research output: Contribution to journalArticle

Abstract

A variety of patient- and product-related factors influenced the outcome of 6379 transfusions given to 533 patients in the Trial to Reduce Alloimmunization to Platelets (TRAP). Responses measured were platelet increments, interval between platelet transfusions, and platelet refractoriness. Patient factors that improved platelet responses were splenectomy and increasing patient age. In contrast, at least 2 prior pregnancies, male gender, splenomegaly, bleeding, fever, infection, disseminated intravascular coagulation, increasing height and weight, lymphocytotoxic antibody positivity, an increasing number of platelet transfusions, or receiving heparin or amphotericin were associated with decreased posttransfusion platelet responses. Platelet factors that were associated with improved platelet responses were giving ABO-compatible platelets, platelets stored for 48 hours or less, and giving large doses of platelets while ultraviolet B (UV-B) or gamma irradiation decreased platelet responses. However, in alloimmunized lymphocytoxic antibody-positive patients, the immediate increment to UV-B-irradiated platelets was well maintained, whereas all other products showed substantial reductions. Refractoriness to platelet transfusions developed in 27% of the patients. Platelet refractoriness was associated with lymphocytotoxic antibody positivity, heparin administration, fever, bleeding, increasing number of platelet transfusions, increasing weight, at least 2 pregnancies, and male gender. The only factors that reduced platelet refractoriness rates were increasing the dose of platelets transfused or transfusing filtered apheresis platelets.

Original languageEnglish (US)
Pages (from-to)4106-4114
Number of pages9
JournalBlood
Volume105
Issue number10
DOIs
StatePublished - May 15 2005
Externally publishedYes

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

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    Slichter, S. J., Davis, K., Enright, H., Braine, H., Gernsheimer, T., Kao, K. J., Kickler, T., Lee, E., McFarland, J., McCullough, J., Rodey, G., Schiffer, C. A., & Woodson, R. (2005). Factors affecting posttransfusion platelet increments, platelet refractoriness, and platelet transfusion intervals in thrombocytopenic patients. Blood, 105(10), 4106-4114. https://doi.org/10.1182/blood-2003-08-2724