A randomized study of buffy coat platelets in platelet additive solution stored 1-5 versus 6-7 days prior to prophylactic transfusion of allogeneic haematopoietic progenitor cell transplant recipients

Background and Objective Storage of platelets > 5 days provides improved availability, logistical management and decreased outdating. Promising results on in vitro parameters and on in vivo post-transfusion recovery and survival of autologous platelets in healthy volunteers have earlier been shown. To provide additional verification, randomized patient transfusion studies are needed. Materials and Methods Sixty allogeneic haematopoietic progenitor cell transplant recipients were randomized to receive buffy-coat (BC) platelets stored in platelet additive solution (PAS) for 1-5 days the first time a prophylactic transfusion was needed after transplantation, followed the second time by platelets stored for 6-7 days or vice versa. The corrected count increment (CCI) for 1 and 24 h were calculated. Results CCI 1 h and CCI 24 h were higher for platelets stored 1-5 days as compared to 6-7 days, 10 center dot 4 +/- 5 center dot 1 vs. 7 center dot 4 +/- 3 center dot 8 (P < 0 center dot 001) and 5 center dot 4 +/- 4 center dot 1 vs. 2 center dot 6 +/- 2 center dot 6 (P < 0 center dot 001), respectively. Time to next platelet transfusion was significantly longer after a transfusion of platelets stored for 1-5 days as compared to platelets stored for 6-7 days: 2 center dot 2 +/- 1 center dot 1 vs. 1 center dot 6 +/- 0 center dot 8 days, respectively (P < 0 center dot 005). No differences in bleeding events and no transfusion reaction were recorded. Conclusion The advantage of an extension of platelet storage time beyond day 5 should be balanced against the increased need for platelet transfusions that may occur and the conceivable risk of transfusion failure.