RESUMEN
BACKGROUND: Transmission of pathogens through blood transfusion is still of great concern to clinicians, patients and blood providers. Pathogen reduction technologies (PRT) have been successfully applied for the treatment of labile blood components, such as plasma, platelets and whole blood (WB), which are now used in routine in many countries. We report the clinical evaluation of suspension of red blood cells (RBC-S) derived from the WB treated with riboflavin and UV light (RF+UV). STUDY DESIGN AND METHODS: Seventy paediatric patients (0·3-17·1 years old) suffering from different malignant disorders were recruited and assigned to two groups: the control group (C) received transfusions of γ-irradiated RBC-S. The experimental group (T) received RBC-S derived from WB, treated with RF+UV. Clinical efficacy was evaluated during follow-up periods by Hb and Ht increments, and needs for transfusion support. Safety was assessed through active surveillance, recording post-transfusion reactions, anti-erythrocyte's antibody formation, haptoglobin and serum potassium levels. RESULTS: The clinical efficacy of RBC-S in both groups was similar: mean post-transfusion Hb concentration (101·6 ± 7·57 g/l vs. 100 ± 8·3 g/l; P = 0·43), and Ht level (28·5 ± 2·42% vs. 28·2 ± 2·7%; P = 0·66). Transfusion of pathogen-reduced RBC-S did not increase the frequency of transfusion reactions and did not induce an excessive immune response in the follow-up period. CONCLUSION: Transfusion of RBC-S, obtained from pathogen-reduced WB, is a promising method to increase the safety of blood component therapy for paediatric patients with malignant disorders without affecting clinical efficacy. A randomized clinical trial including more patients should follow this pilot study to confirm its results.
Asunto(s)
Seguridad de la Sangre/métodos , Transfusión de Eritrocitos/métodos , Reacción a la Transfusión/epidemiología , Adolescente , Niño , Preescolar , Recuento de Eritrocitos , Transfusión de Eritrocitos/normas , Eritrocitos/efectos de los fármacos , Eritrocitos/efectos de la radiación , Femenino , Humanos , Lactante , Masculino , Riboflavina/farmacología , Reacción a la Transfusión/prevención & control , Rayos UltravioletaRESUMEN
BACKGROUND: The safety of blood component transfusions is still of concern and the use of pathogen reduction (PR) methods is increasing. Limited data are available describing safety and efficacy of PR platelet (PLT) transfusions in children. We report the results of a retrospective evaluation of prophylactic transfusions of PR PLT units treated with riboflavin and ultraviolet light in pediatric patients with malignant disorders. STUDY DESIGN AND METHODS: A total of 137 patients (PR, 51; control, 86) and 432 transfusions (PR, 141; control, 291) with mean age of 11 years were evaluated. The primary clinical efficacy endpoint was the proportion of patients with bleeding on any day of PLT support. Secondary endpoints included 1- and 24-hour PLT increments, corrected count increments (CCIs), and the number of days between PLT transfusions. Safety endpoints included number of posttransfusion adverse reactions. RESULTS: The incidence of bleeding events, severity, and localization of bleeding sites did not differ between the study groups. Posttransfusion PLT counts and 1- and 4-hour CCIs (12.25 ± 4.26 and 25.67 ± 7.11; p < 0.05; PR vs. control, respectively) and 18- to 24-hour CCIs (9.41 ± 6.42 and 12.47 ± 6.25; p < 0.05) after transfusions were significantly lower in the PR group. Transfusion-related adverse event rates did not differ between groups (8.3% vs. 9.8%, p = 0.73). CONCLUSION: In spite of lower numerical increase in PLT count, the hemostatic efficacy and safety of PR PLT transfusions was comparable with the control group. Adverse event rates did not differ between groups, but the sample size was relatively small.
Asunto(s)
Neoplasias/terapia , Transfusión de Plaquetas , Trombocitopenia/terapia , Adolescente , Niño , Preescolar , Femenino , Hemorragia/epidemiología , Hemorragia/etiología , Humanos , Incidencia , Lactante , Masculino , Neoplasias/epidemiología , Estudios Retrospectivos , Trombocitopenia/epidemiología , Trombocitopenia/etiologíaRESUMEN
In-situ Optical Emission Spectroscopy (OES) combined with quantum chemical calculations was used as a powerful tool to find out the exited reactive species existing in plasma discharge during the process of lead sulfide chalcogenide materials deposition. Low temperature nonequilibrium RF (40.68 MHz) plasma at low pressure (0.1 Torr) was employed for initiation of chemical interaction between precursors in the gas phase. Only high-pure elements were utilized as the initial substances. The ration between starting materials in the gas phase and power included into the plasma discharge were the variables. The mechanism of the plasma-chemical reaction was assumed and discussed. The stoichiometry and morphology of the surface of the as-deposited materials were studied by different analytical techniques.