Limited efficacy of leukopoor platelets for prevention of febrile transfusion reactions

Leukopoor red cell components have a reduced incidence of febrile transfusion reactions. An analogous efficacy for leukopoor platelets has not been convincingly established. The authors analyzed the transfusion records of 36 patients (26 women, 10 men) who received leukopoor platelets following febrile reactions to unmodified platelets. These patients received 409 unmodified transfusions (mean/patient 11) with 84 febrile reactions (rate 20.5%). Reaction rates to unmodified, non-HLA-matched single donor platelets (14.0%) and HLA-matched platelets (6.5%) were significantly lower than to pooled concentrates (27.2%) (P less than .01 and P less than .001, respectively). Of 623 leukopoor transfusions (mean/patient 17), 84 resulted in reactions (13.5%). Although leukodepletion significantly lowered the overall reaction rate as compared with unmodified products (P less than .02), a majority of patients (28 of 36) continued to have reactions. When individual reaction rates to unmodified and leukopoor transfusions were compared, only two patients showed a significant decrease in their reaction rate with leukopoor platelets. It appears that most susceptible patients continue to react to leukopoor platelets, particularly when pooled concentrates are used, and many patients show no reduction in reaction rate.