Comparative risk of pulmonary adverse events with transfusion of pathogen reduced and conventional platelet components
Year: 2022
Type: article
Abstract: BACKGROUND: Platelet transfusion carries risk of transfusion-transmitted infection (TTI). Pathogen reduction of platelet components (PRPC) is designed to reduce TTI. Pulmonary adverse events (AEs), including transfusion-related acute lung injury and acute respiratory distress syndrome (ARDS) occur with platelet transfusion. STUDY DESIGN: An open label, sequential cohort study of transfusion-dependent hematology-oncology patients was conducted to compare pulmonary safety of PRPC with conventional PC (CPC). The primary outcome was the incidence of treatment-emergent assisted mechanical ventilation (TEAMV) by non-inferiority. Secondary outcomes included: time to TEAMV, ARDS, pulmonary AEs, peri-transfusion AE, hemorrhagic AE, transfusion reactions (TRs), PC and red blood cell (RBC) use, and mortality. RESULTS: By modified intent-to-treat (mITT), 1068 patients received 5277 PRPC and 1223 patients received 5487 CPC. The cohorts had similar demographics, primary disease, and primary therapy. PRPC were non-inferior to CPC for TEAMV (treatment difference -1.7%, 95% CI: (-3.3% to -0.1%); odds ratio = 0.53, 95% CI: (0.30, 0.94). The cumulative incidence of TEAMV for PRPC (2.9%) was significantly less than CPC (4.6%, p = .039). The incidence of ARDS was less, but not significantly different, for PRPC (1.0% vs. 1.8%, p = .151; odds ratio = 0.57, 95% CI: (0.27, 1.18). AE, pulmonary AE, and mortality were not different between cohorts. TRs were similar for PRPC and CPC (8.3% vs. 9.7%, p = .256); and allergic TR were significantly less with PRPC (p = .006). PC and RBC use were not increased with PRPC. DISCUSSION: PRPC demonstrated reduced TEAMV with no excess treatment-related pulmonary morbidity.
Source: Transfusion
DOI: 10.1111/trf.16987
Authors: Edward L. Snyder, Allison P. Wheeler, Majed Refaai, Claudia S. Cohn, Jessica Poisson, Magali Fontaine, Mary Sehl, Ajay K. Nooka, Lynne Uhl, Philip Spinella, Maly Fenelus, Darla Liles, Thomas Coyle, Joanne Becker, Michael Jeng, Eric A. Gehrie, Bryan R. Spencer, Pampee Young, Andrew Johnson, Jennifer J. O'Brien, Gary J. Schiller, John D. Roback, Elizabeth Malynn, Ronald Jackups, Scott T. Avecilla, Jin‐Sying Lin, Kathy Liu, Stanley Bentow, Ho‐Lan Peng, Jeanne Varrone, Richard J. Benjamin, Laurence M. Corash
Institutions: Yale University, Vanderbilt University Medical Center, University of Rochester Medicine, University of Rochester, University of Minnesota Medical Center, Duke Medical Center, University of Maryland Medical Center, University of California, Los Angeles, Ronald Reagan UCLA Medical Center, UCLA Medical Center, Emory University, Beth Israel Deaconess Medical Center, Harvard University, University of Pittsburgh Medical Center, Memorial Sloan Kettering Cancer Center, East Carolina University, TriHealth, Roswell Park Comprehensive Cancer Center, Stanford Medicine, Stanford University, Johns Hopkins University, Johns Hopkins Medicine, Johns Hopkins Hospital, American Red Cross, Mayo Clinic in Florida, Washington University in St. Louis, Cerus (United States)
Language: English
Subfield: Biochemistry
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,900
OpenAlex ID: W4283385019