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Comparative risk of pulmonary adverse events with transfusion of pathogen reduced and conventional platelet components.

Publication ,  Journal Article
Snyder, EL; Wheeler, AP; Refaai, M; Cohn, CS; Poisson, J; Fontaine, M; Sehl, M; Nooka, AK; Uhl, L; Spinella, P; Fenelus, M; Liles, D; Jeng, M ...
Published in: Transfusion
July 2022

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.

Duke Scholars

Published In

Transfusion

DOI

EISSN

1537-2995

Publication Date

July 2022

Volume

62

Issue

7

Start / End Page

1365 / 1376

Location

United States

Related Subject Headings

  • Transfusion Reaction
  • Respiratory Distress Syndrome
  • Platelet Transfusion
  • Photosensitizing Agents
  • Humans
  • Cohort Studies
  • Cardiovascular System & Hematology
  • Blood Transfusion
  • Blood Platelets
  • 3204 Immunology
 

Citation

APA
Chicago
ICMJE
MLA
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Snyder, E. L., Wheeler, A. P., Refaai, M., Cohn, C. S., Poisson, J., Fontaine, M., … Corash, L. M. (2022). Comparative risk of pulmonary adverse events with transfusion of pathogen reduced and conventional platelet components. Transfusion, 62(7), 1365–1376. https://doi.org/10.1111/trf.16987
Snyder, Edward L., Allison P. Wheeler, Majed Refaai, Claudia S. Cohn, Jessica Poisson, Magali Fontaine, Mary Sehl, et al. “Comparative risk of pulmonary adverse events with transfusion of pathogen reduced and conventional platelet components.Transfusion 62, no. 7 (July 2022): 1365–76. https://doi.org/10.1111/trf.16987.
Snyder EL, Wheeler AP, Refaai M, Cohn CS, Poisson J, Fontaine M, et al. Comparative risk of pulmonary adverse events with transfusion of pathogen reduced and conventional platelet components. Transfusion. 2022 Jul;62(7):1365–76.
Snyder, Edward L., et al. “Comparative risk of pulmonary adverse events with transfusion of pathogen reduced and conventional platelet components.Transfusion, vol. 62, no. 7, July 2022, pp. 1365–76. Pubmed, doi:10.1111/trf.16987.
Snyder EL, Wheeler AP, Refaai M, Cohn CS, Poisson J, Fontaine M, Sehl M, Nooka AK, Uhl L, Spinella P, Fenelus M, Liles D, Coyle T, Becker J, Jeng M, Gehrie EA, Spencer BR, Young P, Johnson A, O’Brien JJ, Schiller GJ, Roback JD, Malynn E, Jackups R, Avecilla ST, Lin J-S, Liu K, Bentow S, Peng H-L, Varrone J, Benjamin RJ, Corash LM. Comparative risk of pulmonary adverse events with transfusion of pathogen reduced and conventional platelet components. Transfusion. 2022 Jul;62(7):1365–1376.
Journal cover image

Published In

Transfusion

DOI

EISSN

1537-2995

Publication Date

July 2022

Volume

62

Issue

7

Start / End Page

1365 / 1376

Location

United States

Related Subject Headings

  • Transfusion Reaction
  • Respiratory Distress Syndrome
  • Platelet Transfusion
  • Photosensitizing Agents
  • Humans
  • Cohort Studies
  • Cardiovascular System & Hematology
  • Blood Transfusion
  • Blood Platelets
  • 3204 Immunology