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The impact of platelet transfusion characteristics on posttransfusion platelet increments and clinical bleeding in patients with hypoproliferative thrombocytopenia

机译:增殖性血小板减少症患者血小板输注特征对输血后血小板增量和临床出血的影响

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摘要

Platelet characteristics, such as platelet dose, platelet source (apheresis vs pooled), platelet donor-recipient ABO compatibility, and duration of platelet storage, can affect posttransfusion platelet increments, but it is unclear whether these factors impact platelet transfusion efficacy on clinical bleeding. We performed secondary analyses of platelet transfusions given in the prospective randomized Platelet Dose Study, which included 1272 platelet-transfused hematology-oncology patients who received 6031 prophylactic platelet transfusions. The primary outcome of these analyses was time from first transfusion to first World Health Organization ≥ grade 2 bleeding. Platelet transfusion increments were assessed at 0.25 to 4 hours and 16 to 32 hours after platelet transfusion. There were 778 patients evaluable for analysis of time to bleeding. Adjusted models showed that randomized dose strategy, platelet source, ABO compatibility, and duration of storage did not predict this outcome. Platelet increments were generally higher for transfusions of apheresis platelets, ABO-identical platelets, and platelets stored 3 days versus 4 to 5 days. Thus, although platelet source, ABO compatibility, and duration of storage exert a modest impact on both absolute and corrected posttransfusion platelet increments, they have no measurable impact on prevention of clinical bleeding. This trial was registered at as #.
机译:血小板特征,例如血小板剂量,血小板来源(分离与合并),血小板供体-受体ABO的相容性以及血小板储存的持续时间,可能会影响输血后血小板的增加,但尚不清楚这些因素是否影响血小板输注对临床出血的疗效。我们对前瞻性随机血小板剂量研究进行了血小板输注的二级分析,其中包括1272例接受了6031例预防性血小板输注的血液肿瘤患者。这些分析的主要结果是从第一次输血到第一次世界卫生组织≥2级出血的时间。血小板输注后0.25至4小时和16至32小时评估血小板输注增量。有778例可以评估出血时间的患者。调整后的模型表明,随机剂量策略,血小板来源,ABO相容性和储存时间不能预测这一结果。对于单采单采血小板,ABO相同的血小板,以及储存3天的血小板与4至5天的血小板,血小板增量通常较高。因此,尽管血小板来源,ABO相容性和储存时间对绝对和校正后的输血后血小板增量均产生适度的影响,但它们对预防临床出血没有可测量的影响。该试用版注册为#。

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