Clinical consequences of alterations in platelet transfusion dose: a prospective, randomized, double-blind trial
BACKGROUND: The dose‐response relationship for platelet transfusion has become increasingly important as the use of platelet transfusion has grown. STUDY DESIGN AND METHODS: One hundred fifty‐eight prophylactic apheresis platelet transfusions were administered to 46 patients undergoing high‐dose the...
Gespeichert in:
| Veröffentlicht in: | Transfusion (Philadelphia, Pa.) Pa.), 1999-07, Vol.39 (7), p.674-681 |
|---|---|
| Hauptverfasser: | , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 681 |
|---|---|
| container_issue | 7 |
| container_start_page | 674 |
| container_title | Transfusion (Philadelphia, Pa.) |
| container_volume | 39 |
| creator | Klumpp, T.R. Herman, J.H. Gaughan, J.P. Russo, R.R. Christman, R.A. Goldberg, S.L. Ackerman, S.J. Bleecker, G.C. Mangan, K.F. |
| description | BACKGROUND: The dose‐response relationship for platelet transfusion has become increasingly important as the use of platelet transfusion has grown.
STUDY DESIGN AND METHODS: One hundred fifty‐eight prophylactic apheresis platelet transfusions were administered to 46 patients undergoing high‐dose therapy followed by hematopoietic progenitor cell transplantation in a prospective, randomized, double‐blind, multiple‐crossover study. Transfusions were administered in pairs, differing only in platelet content. Each pair consisted of a lower‐dose platelet component (LDP) and a higher‐dose platelet component (HDP) administered in random order to the same patient. LDPs contained a mean of 3.1 × 1011 platelets (range, 2.3‐3.5 × 1011), and HDPs contained a mean of 5.0 × 1011 platelets (range, 4.5‐6.1 × 1011). Patients with active bleeding and those who were refractory to platelet transfusions were excluded.
RESULTS: The mean posttransfusion platelet count increment with LDP was 17,010 per μL, and that with HDP was 31,057 per μL (p |
| doi_str_mv | 10.1046/j.1537-2995.1999.39070674.x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_69899554</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>69899554</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5114-574864233fe5fa27b6c5cb1d601dd9799ba8b8a6c0556ab12952edbe609f93f3</originalsourceid><addsrcrecordid>eNqVkFFv0zAQxy0EYmXwFZAl0J6WzI5jJ4anqdCCNECgSpV4sRznIrm4SYgT6Pj0XJVu7JUny3e_-9v3I-QVZylnubrapVyKIsm0linXWqdCs4KpIk8Pj8jivveYLBjLecK5yM7Isxh3jLFMM_6UnGEOVguxIP0y-NY7G6jr2gg_J2gdRNo11IYRBjt6LFPf0j7YEQKMdBxsG5spYoPWXYQ31NJ-6GIPbvS_4JJiv-72_g_UlwhMVYCkwkdqnPQ2PCdPGhsivDid52Szer9Zfkhuvqw_Lq9vEic5zxNZ5KXKMyEakI3Niko56SpeK8brWhdaV7asSqsck1LZimdaZlBXoJhutGjEObmYY_FruFQczd5HByHYFropGqVLdCRzBN_OoMMd4gCN6Qe_t8Ot4cwcfZudOTo1R6fm6Nvc-TYHnH55emaq9lA_mJ0FI_D6BNiIlhuU43z8x5VKsVIi9m7GfvsAt__zBbP5trq7YUwyx_g4wuE-xg4_jCpEIc3289pst9_Xn1bZV7MVfwFwua6m</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>69899554</pqid></control><display><type>article</type><title>Clinical consequences of alterations in platelet transfusion dose: a prospective, randomized, double-blind trial</title><source>MEDLINE</source><source>Wiley Online Library All Journals</source><creator>Klumpp, T.R. ; Herman, J.H. ; Gaughan, J.P. ; Russo, R.R. ; Christman, R.A. ; Goldberg, S.L. ; Ackerman, S.J. ; Bleecker, G.C. ; Mangan, K.F.</creator><creatorcontrib>Klumpp, T.R. ; Herman, J.H. ; Gaughan, J.P. ; Russo, R.R. ; Christman, R.A. ; Goldberg, S.L. ; Ackerman, S.J. ; Bleecker, G.C. ; Mangan, K.F.</creatorcontrib><description>BACKGROUND: The dose‐response relationship for platelet transfusion has become increasingly important as the use of platelet transfusion has grown.
STUDY DESIGN AND METHODS: One hundred fifty‐eight prophylactic apheresis platelet transfusions were administered to 46 patients undergoing high‐dose therapy followed by hematopoietic progenitor cell transplantation in a prospective, randomized, double‐blind, multiple‐crossover study. Transfusions were administered in pairs, differing only in platelet content. Each pair consisted of a lower‐dose platelet component (LDP) and a higher‐dose platelet component (HDP) administered in random order to the same patient. LDPs contained a mean of 3.1 × 1011 platelets (range, 2.3‐3.5 × 1011), and HDPs contained a mean of 5.0 × 1011 platelets (range, 4.5‐6.1 × 1011). Patients with active bleeding and those who were refractory to platelet transfusions were excluded.
RESULTS: The mean posttransfusion platelet count increment with LDP was 17,010 per μL, and that with HDP was 31,057 per μL (p<0.0001). Only 37 percent of LDPs resulted in platelet count increments of at least 20,000 per μL, whereas 81 percent of HDPs resulted in increments above this level (p<0.0001). The mean transfusion‐free interval with LDP was 2.16 days, whereas that with HDP was 3.03 days (p<0.01). Administration of LDPs was associated with a 39 to 82 percent increase in the relative risk (per day) of requiring subsequent platelet transfusions (p<0.0001).
CONCLUSION: As compared to the administration of HDPs, the administration of LDPs for prophylactic transfusion in hematopoietic progenitor cell transplant patients results in a lower platelet count increment, a lower likelihood of obtaining a posttransfusion platelet increment >20,000 per μL, a shorter transfusion‐free interval, and a greater relative risk per day of requiring additional transfusions.</description><identifier>ISSN: 0041-1132</identifier><identifier>EISSN: 1537-2995</identifier><identifier>DOI: 10.1046/j.1537-2995.1999.39070674.x</identifier><identifier>PMID: 10413273</identifier><identifier>CODEN: TRANAT</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Science Inc</publisher><subject>Adolescent ; Adult ; Analysis of Variance ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis ; Cross-Over Studies ; Double-Blind Method ; Female ; HDP(s) = higher-dose platelet component(s) ; Histocompatibility Testing ; HPCT = hematopoietic progenitor cell transplantation ; Humans ; LDP(s) = lower-dose platelet component(s) ; Male ; Medical sciences ; Middle Aged ; Platelet Count ; Platelet Transfusion ; Prospective Studies ; Thrombocytopenia - therapy ; Time Factors ; Transfusions. Complications. Transfusion reactions. Cell and gene therapy</subject><ispartof>Transfusion (Philadelphia, Pa.), 1999-07, Vol.39 (7), p.674-681</ispartof><rights>1999 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5114-574864233fe5fa27b6c5cb1d601dd9799ba8b8a6c0556ab12952edbe609f93f3</citedby><cites>FETCH-LOGICAL-c5114-574864233fe5fa27b6c5cb1d601dd9799ba8b8a6c0556ab12952edbe609f93f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1046%2Fj.1537-2995.1999.39070674.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1046%2Fj.1537-2995.1999.39070674.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1866085$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10413273$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Klumpp, T.R.</creatorcontrib><creatorcontrib>Herman, J.H.</creatorcontrib><creatorcontrib>Gaughan, J.P.</creatorcontrib><creatorcontrib>Russo, R.R.</creatorcontrib><creatorcontrib>Christman, R.A.</creatorcontrib><creatorcontrib>Goldberg, S.L.</creatorcontrib><creatorcontrib>Ackerman, S.J.</creatorcontrib><creatorcontrib>Bleecker, G.C.</creatorcontrib><creatorcontrib>Mangan, K.F.</creatorcontrib><title>Clinical consequences of alterations in platelet transfusion dose: a prospective, randomized, double-blind trial</title><title>Transfusion (Philadelphia, Pa.)</title><addtitle>Transfusion</addtitle><description>BACKGROUND: The dose‐response relationship for platelet transfusion has become increasingly important as the use of platelet transfusion has grown.
STUDY DESIGN AND METHODS: One hundred fifty‐eight prophylactic apheresis platelet transfusions were administered to 46 patients undergoing high‐dose therapy followed by hematopoietic progenitor cell transplantation in a prospective, randomized, double‐blind, multiple‐crossover study. Transfusions were administered in pairs, differing only in platelet content. Each pair consisted of a lower‐dose platelet component (LDP) and a higher‐dose platelet component (HDP) administered in random order to the same patient. LDPs contained a mean of 3.1 × 1011 platelets (range, 2.3‐3.5 × 1011), and HDPs contained a mean of 5.0 × 1011 platelets (range, 4.5‐6.1 × 1011). Patients with active bleeding and those who were refractory to platelet transfusions were excluded.
RESULTS: The mean posttransfusion platelet count increment with LDP was 17,010 per μL, and that with HDP was 31,057 per μL (p<0.0001). Only 37 percent of LDPs resulted in platelet count increments of at least 20,000 per μL, whereas 81 percent of HDPs resulted in increments above this level (p<0.0001). The mean transfusion‐free interval with LDP was 2.16 days, whereas that with HDP was 3.03 days (p<0.01). Administration of LDPs was associated with a 39 to 82 percent increase in the relative risk (per day) of requiring subsequent platelet transfusions (p<0.0001).
CONCLUSION: As compared to the administration of HDPs, the administration of LDPs for prophylactic transfusion in hematopoietic progenitor cell transplant patients results in a lower platelet count increment, a lower likelihood of obtaining a posttransfusion platelet increment >20,000 per μL, a shorter transfusion‐free interval, and a greater relative risk per day of requiring additional transfusions.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Analysis of Variance</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis</subject><subject>Cross-Over Studies</subject><subject>Double-Blind Method</subject><subject>Female</subject><subject>HDP(s) = higher-dose platelet component(s)</subject><subject>Histocompatibility Testing</subject><subject>HPCT = hematopoietic progenitor cell transplantation</subject><subject>Humans</subject><subject>LDP(s) = lower-dose platelet component(s)</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Platelet Count</subject><subject>Platelet Transfusion</subject><subject>Prospective Studies</subject><subject>Thrombocytopenia - therapy</subject><subject>Time Factors</subject><subject>Transfusions. Complications. Transfusion reactions. Cell and gene therapy</subject><issn>0041-1132</issn><issn>1537-2995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqVkFFv0zAQxy0EYmXwFZAl0J6WzI5jJ4anqdCCNECgSpV4sRznIrm4SYgT6Pj0XJVu7JUny3e_-9v3I-QVZylnubrapVyKIsm0linXWqdCs4KpIk8Pj8jivveYLBjLecK5yM7Isxh3jLFMM_6UnGEOVguxIP0y-NY7G6jr2gg_J2gdRNo11IYRBjt6LFPf0j7YEQKMdBxsG5spYoPWXYQ31NJ-6GIPbvS_4JJiv-72_g_UlwhMVYCkwkdqnPQ2PCdPGhsivDid52Szer9Zfkhuvqw_Lq9vEic5zxNZ5KXKMyEakI3Niko56SpeK8brWhdaV7asSqsck1LZimdaZlBXoJhutGjEObmYY_FruFQczd5HByHYFropGqVLdCRzBN_OoMMd4gCN6Qe_t8Ot4cwcfZudOTo1R6fm6Nvc-TYHnH55emaq9lA_mJ0FI_D6BNiIlhuU43z8x5VKsVIi9m7GfvsAt__zBbP5trq7YUwyx_g4wuE-xg4_jCpEIc3289pst9_Xn1bZV7MVfwFwua6m</recordid><startdate>199907</startdate><enddate>199907</enddate><creator>Klumpp, T.R.</creator><creator>Herman, J.H.</creator><creator>Gaughan, J.P.</creator><creator>Russo, R.R.</creator><creator>Christman, R.A.</creator><creator>Goldberg, S.L.</creator><creator>Ackerman, S.J.</creator><creator>Bleecker, G.C.</creator><creator>Mangan, K.F.</creator><general>Blackwell Science Inc</general><general>Blackwell Publishing</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>199907</creationdate><title>Clinical consequences of alterations in platelet transfusion dose: a prospective, randomized, double-blind trial</title><author>Klumpp, T.R. ; Herman, J.H. ; Gaughan, J.P. ; Russo, R.R. ; Christman, R.A. ; Goldberg, S.L. ; Ackerman, S.J. ; Bleecker, G.C. ; Mangan, K.F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5114-574864233fe5fa27b6c5cb1d601dd9799ba8b8a6c0556ab12952edbe609f93f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Analysis of Variance</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis</topic><topic>Cross-Over Studies</topic><topic>Double-Blind Method</topic><topic>Female</topic><topic>HDP(s) = higher-dose platelet component(s)</topic><topic>Histocompatibility Testing</topic><topic>HPCT = hematopoietic progenitor cell transplantation</topic><topic>Humans</topic><topic>LDP(s) = lower-dose platelet component(s)</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Platelet Count</topic><topic>Platelet Transfusion</topic><topic>Prospective Studies</topic><topic>Thrombocytopenia - therapy</topic><topic>Time Factors</topic><topic>Transfusions. Complications. Transfusion reactions. Cell and gene therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Klumpp, T.R.</creatorcontrib><creatorcontrib>Herman, J.H.</creatorcontrib><creatorcontrib>Gaughan, J.P.</creatorcontrib><creatorcontrib>Russo, R.R.</creatorcontrib><creatorcontrib>Christman, R.A.</creatorcontrib><creatorcontrib>Goldberg, S.L.</creatorcontrib><creatorcontrib>Ackerman, S.J.</creatorcontrib><creatorcontrib>Bleecker, G.C.</creatorcontrib><creatorcontrib>Mangan, K.F.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Transfusion (Philadelphia, Pa.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Klumpp, T.R.</au><au>Herman, J.H.</au><au>Gaughan, J.P.</au><au>Russo, R.R.</au><au>Christman, R.A.</au><au>Goldberg, S.L.</au><au>Ackerman, S.J.</au><au>Bleecker, G.C.</au><au>Mangan, K.F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical consequences of alterations in platelet transfusion dose: a prospective, randomized, double-blind trial</atitle><jtitle>Transfusion (Philadelphia, Pa.)</jtitle><addtitle>Transfusion</addtitle><date>1999-07</date><risdate>1999</risdate><volume>39</volume><issue>7</issue><spage>674</spage><epage>681</epage><pages>674-681</pages><issn>0041-1132</issn><eissn>1537-2995</eissn><coden>TRANAT</coden><abstract>BACKGROUND: The dose‐response relationship for platelet transfusion has become increasingly important as the use of platelet transfusion has grown.
STUDY DESIGN AND METHODS: One hundred fifty‐eight prophylactic apheresis platelet transfusions were administered to 46 patients undergoing high‐dose therapy followed by hematopoietic progenitor cell transplantation in a prospective, randomized, double‐blind, multiple‐crossover study. Transfusions were administered in pairs, differing only in platelet content. Each pair consisted of a lower‐dose platelet component (LDP) and a higher‐dose platelet component (HDP) administered in random order to the same patient. LDPs contained a mean of 3.1 × 1011 platelets (range, 2.3‐3.5 × 1011), and HDPs contained a mean of 5.0 × 1011 platelets (range, 4.5‐6.1 × 1011). Patients with active bleeding and those who were refractory to platelet transfusions were excluded.
RESULTS: The mean posttransfusion platelet count increment with LDP was 17,010 per μL, and that with HDP was 31,057 per μL (p<0.0001). Only 37 percent of LDPs resulted in platelet count increments of at least 20,000 per μL, whereas 81 percent of HDPs resulted in increments above this level (p<0.0001). The mean transfusion‐free interval with LDP was 2.16 days, whereas that with HDP was 3.03 days (p<0.01). Administration of LDPs was associated with a 39 to 82 percent increase in the relative risk (per day) of requiring subsequent platelet transfusions (p<0.0001).
CONCLUSION: As compared to the administration of HDPs, the administration of LDPs for prophylactic transfusion in hematopoietic progenitor cell transplant patients results in a lower platelet count increment, a lower likelihood of obtaining a posttransfusion platelet increment >20,000 per μL, a shorter transfusion‐free interval, and a greater relative risk per day of requiring additional transfusions.</abstract><cop>Oxford, UK</cop><pub>Blackwell Science Inc</pub><pmid>10413273</pmid><doi>10.1046/j.1537-2995.1999.39070674.x</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0041-1132 |
| ispartof | Transfusion (Philadelphia, Pa.), 1999-07, Vol.39 (7), p.674-681 |
| issn | 0041-1132 1537-2995 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_69899554 |
| source | MEDLINE; Wiley Online Library All Journals |
| subjects | Adolescent Adult Analysis of Variance Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis Cross-Over Studies Double-Blind Method Female HDP(s) = higher-dose platelet component(s) Histocompatibility Testing HPCT = hematopoietic progenitor cell transplantation Humans LDP(s) = lower-dose platelet component(s) Male Medical sciences Middle Aged Platelet Count Platelet Transfusion Prospective Studies Thrombocytopenia - therapy Time Factors Transfusions. Complications. Transfusion reactions. Cell and gene therapy |
| title | Clinical consequences of alterations in platelet transfusion dose: a prospective, randomized, double-blind trial |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-29T03%3A47%3A44IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Clinical%20consequences%20of%20alterations%20in%20platelet%20transfusion%20dose:%20a%20prospective,%20randomized,%20double-blind%20trial&rft.jtitle=Transfusion%20(Philadelphia,%20Pa.)&rft.au=Klumpp,%20T.R.&rft.date=1999-07&rft.volume=39&rft.issue=7&rft.spage=674&rft.epage=681&rft.pages=674-681&rft.issn=0041-1132&rft.eissn=1537-2995&rft.coden=TRANAT&rft_id=info:doi/10.1046/j.1537-2995.1999.39070674.x&rft_dat=%3Cproquest_cross%3E69899554%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=69899554&rft_id=info:pmid/10413273&rfr_iscdi=true |