Leukocyte-depleted blood components prevent platelet refractoriness in patients with acute myeloid leukemia.

Abstract

Platelet refractoriness arising from HLA immunization develops in 20-50% of multitransfused patients with hematologic malignancies. We retrospectively analyzed the efficiency of leukocyte-depleted blood components in preventing refractoriness in 140 adult patients with acute myeloid leukemia (AML), treated according to a standardized cytostatic protocol. Sixty-eight patients received leukocyte-depleted (L-D) platelet concentrates (PCs) and red cells (RBCs), with fewer than 10(6) leukocytes per unit, and 72 patients received standard (STD) blood components. Two of 67 (3%) evaluable patients in the leukocyte-depleted group and 14 of 68 (21%) in the standard group became refractory during the median follow-up time of 229 days. Nine of 24 (37%) previously pregnant women in the STD group but none of 17 in the L-D group became refractory. Twenty patients were shifted during later treatment from L-D to STD PCs; none became refractory. Corrected platelet increments (CI) at 18 hours were higher after STD PCs (6.50 than L-D PCs (5.2), but more PCs and RBCs were transfused per patient in the STD group. It is concluded that effective leukocyte depletion prevents platelet refractoriness in patients with AML, even in those with previous immunization, and reduces the consumption of blood components.