REFRACTORINESS TO PLATELET TRANSFUSIONS IN CHILDREN WITH ACUTE-LEUKEMIA

被引:7
作者
DECOTEAU, J
HADDAD, S
BLANCHETTE, V
POON, A
机构
[1] Division of Hematology/Oncology, Hospital for Sick Children, Toronto, ON
关键词
BLOOD COMPONENT TRANSFUSION; PLATELET TRANSFUSION; LEUKEMIA;
D O I
10.1097/00043426-199511000-00005
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: We evaluated the incidence of clinically significant refractoriness to platelet transfusions in children with acute leukemia. Patients and Methods: We reviewed the complete transfusion records up to July 1993 of all 213 patients diagnosed with acute leukemia at our institution over the 4-year period 1987 to 1990. The transfusion protocol called for all patients requiring transfusion of red cell and/or platelet concentrates to initially receive components that were not leukocyte reduced. Patients suspected clinically to be refractory to platelets were tested for anti-human leukocyte antigen (HLA) antibodies and those that tested positive were switched to HLA-matched platelets. Results: Of 184 patients diagnosed with acute lymphoblastic leukemia(ALL), 133 (72%) required platelet support, whereas all 29 patients with acute myeloid leukemia (AML) were transfused with platelets. The incidence of clinically suspected refractoriness to non-leukocyte- reduced platelets, which was confirmed by a positive test for anti-HLA antibodies and which resulted in a switch to HLA-matched platelets, was nine of 29 (31%) for patients with AML but only three of 133 (2.3%) for patients with ALL. Conclusions: The results of this study indicate that clinically significant platelet refractoriness requiring transfusion of HLA-matched platelets occurs infrequently in childhood ALL. For this group of patients, use of leukocyte-depleted cellular components for the purpose of preventing platelet refractoriness cannot be justified. This approach may be appropriate for children with AML.
引用
收藏
页码:306 / 310
页数:5
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