Efficacy and safety of pathogen-reduced platelet concentrates in children with cancer: a retrospective cohort study

BACKGROUNDThe safety of blood component transfusions is still of concern and the use of pathogen reduction (PR) methods is increasing. Limited data are available describing safety and efficacy of PR platelet (PLT) transfusions in children. We report the results of a retrospective evaluation of prophylactic transfusions of PR PLT units treated with riboflavin and ultraviolet light in pediatric patients with malignant disorders. STUDY DESIGN AND METHODSA total of 137 patients (PR, 51; control, 86) and 432 transfusions (PR, 141; control, 291) with mean age of 11 years were evaluated. The primary clinical efficacy endpoint was the proportion of patients with bleeding on any day of PLT support. Secondary endpoints included 1- and 24-hour PLT increments, corrected count increments (CCIs), and the number of days between PLT transfusions. Safety endpoints included number of posttransfusion adverse reactions. RESULTSThe incidence of bleeding events, severity, and localization of bleeding sites did not differ between the study groups. Posttransfusion PLT counts and 1- and 4-hour CCIs (12.254.26 and 25.67 +/- 7.11; p<0.05; PR vs. control, respectively) and 18- to 24-hour CCIs (9.41 +/- 6.42 and 12.47 +/- 6.25; p<0.05) after transfusions were significantly lower in the PR group. Transfusion-related adverse event rates did not differ between groups (8.3% vs. 9.8%, p=0.73). CONCLUSIONIn spite of lower numerical increase in PLT count, the hemostatic efficacy and safety of PR PLT transfusions was comparable with the control group. Adverse event rates did not differ between groups, but the sample size was relatively small.