[Post-transfusional platelet increment: effect of clinical factors]

The results of platelet transfusions depend upon a variety of different conditions; besides alloimmunization, a lot of clinical factors are responsible for transfusion success. The present paper tries to work out clinical findings, which are related to successful or unsuccessful platelet transfusions. The following criteria could be identified to influence posttransfusion platelet increment: hepatomegaly, splenomegaly, diagnosis, antibiotics, number and time of previous platelet transfusions. AB0 compatibility, pretransfusion storage time and leucocyte contamination. Therefore, in platelet transfusion therapy a high value should be set on AB0 compatibility, brief storage time and low leucocyte contamination, since these parameters--in contrast to the other influencing factors--can easily be controlled.

Influence of antibiotics on posttransfusion platelet increment

BACKGROUND

Fever has been identified as a major cause of platelet refractoriness. However, it is regularly attended by the administration of antibiotics, and thus it cannot be determined whether fever, the administration of antibiotics, or both are responsible for the reduced platelet increment. The present study was undertaken to discern the effect of body temperature and antibiotics on transfusion success.

STUDY DESIGN AND METHODS

Single-donor platelet transfusions (n = 400) were monitored retrospectively. Besides other influencing factors (e.g., spleen size, number of previous transfusions, diagnosis, bone marrow transplantation), body temperature and the administration of antibiotics were documented from the patients' records. To distinguish the effects of fever and antibiotics, a general mixed model of variance was used for analysis.

RESULTS

Besides the well-known factors of splenomegaly, hepatomegaly, bone marrow transplantation, and pretransfusion storage time, both body temperature and antibiotics independently reduced the corrected count increment. Among the various antibiotics, amphotericin B, ciprofloxacin, and vancomycin had the greatest influence.

CONCLUSION

The administration of antibiotics has a negative effect on the corrected count increment, independent of the presence of fever. Besides amphotericin B, which has previously been shown to influence the corrected count increment, vancomycin and ciprofloxacin reduce it significantly. Because these antibiotics are widely used in patients with bone marrow failure, these observations should be proven by further prospective in vivo and in vitro studies.

[Post-transfusion rise in thrombocytes: observations in a hematologic-oncologic patient sample]

OBJECTIVE

Aim of the present analysis was the evaluation of clinical conditions and product-specific parameters influencing posttransfusion platelet increment.

DESIGN

400 single-donor platelet transfusions were analyzed for patient- and concentrate-specific factors influencing posttransfusion platelet increment. Statistical analysis was performed by the General Mixed Model Analysis of Variance.

SETTING

Department of hematology and oncology at a university hospital.

PATIENTS

46 patients (24 male, 22 female; age 17-80 years).

INTERVENTIONS

Single-donor platelet transfusions.

RESULTS

As demonstrated earlier, splenomegaly, body temperature, and bone marrow transplantation could be proven as factors reducing posttransfusion platelet increment. In addition, hepatomegaly and application of antibiotics had negative effects on platelet increment. Among the product-specific parameters leukocyte contamination and pretransfusion storage time reduced transfusion success significantly.

CONCLUSIONS

Clinical factors influencing posttransfusion platelet increment can hardly be controlled. In contrast, concentrate-specific parameters can be influenced by preparation technique and storage procedure. Therefore, high value should be set on low leukocyte contamination and short pretransfusion storage time of platelet concentrates.