Comparison of post transfusion platelet response following random donor and apheresis platelets

Background: Corrected count increment (CCI) and percent recovery (%R) are mathematical calculations used to indicate the effectiveness of a platelet transfusion. A transfusion is deemed successful if the 18-24 hour CCI is <4.5 x lO'/L or %R <20. Data collected during a randomized controlled trial were analysed to compare the post transfusion platelet response following infusion of three types of platelet products: plasma removed platelets (PR); random donor platelets leukoreduced pre-storage by filtration PRE-RD; and, pre-storage leukoreduced apheresis platelets (PRE-AP). Study Design: Platelet transfusions for eligible adult patients with hématologie malignancies were assigned in random order to be one of three types: PR, PRE-RD, or PRE-AP. The standard transfusion trigger was <15xlO'/L. Platelet counts were performed pre and 18-24 hours post trasnfusion, and the percentage of successful transfusions calculated based on the criteria defined above. The median time to the next trasnfusion (TNT) was calculated for each product type to determine if the post trasnfusion platelet response affected the duration of the interval between transfusions. Results: A total of 854 transfusions given to 129 patients were included in the analyses. The results indicating successful transfusions are summarized in the table below. The rates of successful transfusions were significantly higher with the pre-storage leukoreduced apheresis platelets compared to the other two types of products. The median time to next transfusion was one day for the PR and PRE-RD groups and two days for PRE-AP group. Conclusion: PRE-AP platelets were associated with a higher frequency of successful transfusions than PR and PRE-RD. This appears to be associated with a longer time interval between transfusions which could result in fewer platelet requirements. No. Successful Tx (%) PR PRE-RD PRE-AP P VALUE CCI 50/130(38%) 128/367(35%) 188/357(53%) 0.00005 %R 48/130(37%) 127/367(35%) 185/357(52%) 0.00008 PR and PRE-RD versus PRE-AP.