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Published on: January 31, 2018
Replaced platelet concentrates containing a new additive solution, M-sol: safety and efficacy for pediatric patients
Ryu Yanagisawa1, Shigetaka Shimodaira, Shunsuke Kojima
1Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan; Division of Blood Transfusion, Shinshu University Hospital, Matsumoto, Japan; Hokkaido Red Cross Blood Center, Sapporo, Japan; Department of Pediatrics, Asahikawa Medical University School of Medicine, Asahikawa, Japan.
Insights
Platelet concentrates containing M-sol (M-sol-R-PCs) significantly reduced allergic transfusion reactions (ATRs) in children compared to plasma-rich platelet concentrates (P-PCs). This switch maintained transfusion efficacy, offering a safer alternative for pediatric patients.
Area of Science:
- Transfusion Medicine
- Pediatric Hematology
- Immunology
Background:
- Allergic transfusion reactions (ATRs) are a significant concern, especially with plasma-rich platelet concentrates (P-PCs).
- M-sol-R-PCs are proposed as a preventative measure against ATRs.
- Clinical evidence supporting M-sol-R-PCs efficacy in preventing ATRs is limited.
Purpose of the Study:
- To evaluate the efficacy of M-sol-R-PCs in preventing ATRs in pediatric patients.
- To compare the frequency and severity of ATRs between M-sol-R-PCs and P-PCs.
- To assess transfusion efficiency, including corrected count increment (CCI), for both types of platelet concentrates.
Main Methods:
- A retrospective cohort study comparing pediatric patients receiving P-PCs (2008-2011) and M-sol-R-PCs (2010-2011).
- Patients had hematologic disorders, solid tumors, primary immunodeficiency, or inherited metabolic disorders.
- Data collected on ATRs, CCI, and bleeding over six months per patient.
Main Results:
- M-sol-R-PCs significantly reduced ATRs (0.3% per bag) compared to P-PCs (3.3% per bag).
- No significant difference in 24-hour corrected count increment (CCI) was observed between M-sol-R-PCs and P-PCs.
- Two patients (4.1%) experienced Grade 1 ATRs with M-sol-R-PCs, versus 14 patients (17.9%) with P-PCs.
Conclusions:
- M-sol-R-PCs are effective in preventing ATRs in pediatric patients without compromising transfusion efficiency.
- Further validation through prospective clinical trials is recommended to confirm these findings.
- M-sol-R-PCs represent a promising alternative for reducing transfusion-related adverse events in children.
Background:
Allergic transfusion reactions (ATRs), particularly those caused by plasma-rich platelet concentrates (P-PCs), are an important concern in transfusion medicine. Replacing P-PCs with PCs containing M-sol (M-sol-R-PCs) is expected to prevent ATRs. However, this has not yet been verified by sufficient clinical evidence.
Study Design And Methods:
A retrospective cohort study was performed between 2008 and 2011. Pediatric patients with hematologic disorders, solid tumors, primary immunodeficiency disorders, or inherited metabolic disorders were transfused with M-sol-R-PCs between 2010 and 2011; the transfusions of P-PCs administered between 2008 and 2011 were compared in terms of frequency and severity of ATRs, corrected count increment (CCI), and occurrence of bleeding. Data were collected for 6 consecutive months on a per-patient basis.
Results:
Data obtained during 2008 to 2011 showed that of the 78 patients receiving 515 P-PC transfusions, 14 (17.9%) had 17 ATRs (3.3%); 14 and three ATRs were of Grades 1 and 2, respectively. In 2010 to 2011, 49 patients received 620 transfusions of M-sol-R-PCs, and two patients (4.1%) had Grade 1 ATRs (0.3%). Thus, the frequency of ATRs per bag and per patient differed significantly between the two transfusions. No steroid agents were used for the prevention or treatment of ATRs in the M-sol-R-PC group. The CCI (24 hr) for M-sol-R-PCs did not differ from that for P-PCs.
Conclusion:
M-sol-R-PCs were found to be effective in preventing ATRs without loss of transfusion efficiency in children; however, its efficacy should be further evaluated in prospective clinical trials.
