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Platelet transfusion and survival in adults with acute leukemia

Leukemia volume 22, pages 631–635 (2008)Cite this article

Transfusion is employed in virtually every adult patient with acute leukemia and leads to immunomodulatory effects that are not yet characterized fully.1 These effects include downregulation of Th1 immunity and reciprocal activation of Th2 immunity.2 Thus avoiding, or reversing the effects on cellular immunity due to transfusion in patients with acute leukemia is a potential strategy for improved clinical outcomes. A growing body of data from in vitro animal and clinical studies suggests that blood transfusion has clinically relevant immunologic effects on patients, and that these effects are at least in part due to altered T-cell function.1 The literature on the effects of transfusion on recipient immunologic function and clinical outcomes is extensive but largely restricted to surgical settings. It is not known whether similar effects occur in patients with hematologic malignancies.

Infusion of ABO-mismatched platelets is associated with an increased incidence of multi-organ failure and death in stem cell transplants for acute myeloid leukemia.3 In many centers, the approach to platelet transfusion is to give little or no priority to ABO matching of donors and recipients. One reason is that ABO mismatching of donor and recipient has little effect on clinical outcome in allogeneic stem cell transplantation.4 We hypothesized that immune function may be important in eradicating residual disease during and after induction therapy in acute leukemia and that transfusion might alter immune function. We examined retrospectively the survival in adult patients with acute leukemia who systematically participated in different protocols for transfusion including ABO identical versus non-identical platelets, leukoreduced versus non-leukoreduced transfusions and washed versus unwashed transfusions.

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References

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Author notes

  1. J M Rowe

    Present address: 3Current address: Department of Hematology and BMT, Rambam Medical Center, Haifa 31096, Israel,

Authors and Affiliations

  1. Department of Pathology & Laboratory Medicine, Transfusion Medicine Unit, University of Rochester Medical Center, Rochester, NY, USA

    N Blumberg

  2. Department of Medicine, Hematology-Oncology Division, University of Rochester Medical Center, Rochester, NY, USA

    J M Heal, J L Liesveld, G L Phillips & J M Rowe

Authors
  1. N Blumberg
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  2. J M Heal
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  3. J L Liesveld
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  4. G L Phillips
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  5. J M Rowe
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Corresponding author

Correspondence to N Blumberg.

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Supplementary Information accompanies the paper on the Leukemia website (http://www.nature.com/leu).

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Blumberg, N., Heal, J., Liesveld, J. et al. Platelet transfusion and survival in adults with acute leukemia. Leukemia 22, 631–635 (2008). https://doi.org/10.1038/sj.leu.2404920

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