Assuntos
Transfusão de Componentes Sanguíneos/efeitos adversos , Membrana Celular/efeitos da radiação , Antígenos HLA/imunologia , Imunização , Leucócitos/efeitos da radiação , Reação Transfusional , Raios Ultravioleta , Animais , Células Apresentadoras de Antígenos/imunologia , Plaquetas/imunologia , Plaquetas/efeitos da radiação , Preservação de Sangue/instrumentação , Membrana Celular/imunologia , Cães/sangue , Cães/imunologia , Histocompatibilidade , Humanos , Transfusão de Leucócitos , Leucócitos/imunologia , Agregação Plaquetária/efeitos da radiação , Transfusão de PlaquetasRESUMO
HLA immunization is a common complication of transfusion therapy in 30% to 60% of oncohematologic patients. Evidence shows that leukocytes present in cellular blood products are the main component involved in the occurrence of HLA immunization, and several studies showed that leukocyte-poor blood products are less able to induce it. However, leukocyte-poor platelet concentrates obtained by conventional techniques, ie, centrifugation, frequently have a high level of remaining leukocytes. Cotton wool filter Imugard IG 500 can be used to obtain leukocyte-poor cellular blood products. The technique is easy to perform, even in an emergency, and can be used with either packed RBCs or platelet concentrates. Means of 97%, 92%, and 76% elimination of leukocytes are obtained for packed RBCs, pooled standard platelet concentrates, and single-donor platelet concentrates, respectively. Patients were randomized to receive either standard (control group) or filtered (leukocyte-poor group) blood products. Of 112 randomized patients, 69 were evaluable, 35 in the control group and 34 in the leukocyte-poor group. Both groups are comparable according to age, diagnosis, sex ratio, previous transfusions, and pregnancies. There is a significant difference in regard to the HLA immunization rate (31.4% in the control v 11.7% in the leukocyte-poor group, P less than .05) and frequency of refractoriness to platelet transfusions (46.6% v 11.7%, P less than .05). We conclude that this filtration technique can be an efficient means to reduce the HLA immunization rate in polytransfused oncohematologic patients.