The assessment of platelet function by thromboelastometry as a point‐of‐care test to guide Intercept‐treated platelet support in hemato‐oncological patients and hematopoietic stem cell transplantation recipients
BACKGROUND Pathogen inactivation (PI) techniques for platelet concentrates (PCs) are one of the latest innovations to improve blood safety and reduce the risk of transfusion‐transmitted infections (TTIs). An impaired function and in vivo recovery of platelets as well as an increased PC demand are co...
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| Published in | Transfusion (Philadelphia, Pa.) Vol. 60; no. 7; pp. 1391 - 1399 |
|---|---|
| Main Authors | , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Hoboken, USA
John Wiley & Sons, Inc
01.07.2020
Wiley Subscription Services, Inc |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0041-1132 1537-2995 1537-2995 |
| DOI | 10.1111/trf.15783 |
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| Abstract | BACKGROUND
Pathogen inactivation (PI) techniques for platelet concentrates (PCs) are one of the latest innovations to improve blood safety and reduce the risk of transfusion‐transmitted infections (TTIs). An impaired function and in vivo recovery of platelets as well as an increased PC demand are concerns regarding these techniques. The intent of this study was to evaluate the hemostatic effect of PCs treated with the Intercept™ System by thromboelastometry (TEM) and to assess the clinical validity of its results in comparison to post‐transfusion increase (PTI) and corrected count increment (CCI).
STUDY‐DESIGN AND METHODS
This prospective‐observational study included 47 patients (m:f = 25:22; median age: 54 years [21‐70]) of our Bone Marrow Transplantation unit with hemato‐oncological malignancies transfused with Intercept™‐treated PCs. Serial TEM measurements were performed just before and 1 hour after PC transfusion and were analyzed for their correlation with PTI and CCI as well as for clinical variables.
RESULTS
The majority of our patients had received a hematopoietic stem cell transplantation (HSCT) (n = 41; 87%). In median 9 (1‐50) PCs were transfused. Serial TEM, PTI, and CCI measurements were available for 150 transfusion episodes. The median platelet dose transfused was 2.65 × 1011/unit (1.8‐6). The median CCI was 9.250 (0‐28.000). We observed a significant improvement in TEM parameters (p < 0.05) after transfusion of PI PCs, which did not mandatory correlate with the 1‐hour PTI and CCI.
CONCLUSION
Serial TEM measurements indicate the hemostatic effect of Intercept™‐treated PCs. The 1‐hour PTI and CCI may not appropriately reflect the in vivo function of platelets after PI PC transfusion. |
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| AbstractList | Pathogen inactivation (PI) techniques for platelet concentrates (PCs) are one of the latest innovations to improve blood safety and reduce the risk of transfusion-transmitted infections (TTIs). An impaired function and in vivo recovery of platelets as well as an increased PC demand are concerns regarding these techniques. The intent of this study was to evaluate the hemostatic effect of PCs treated with the Intercept™ System by thromboelastometry (TEM) and to assess the clinical validity of its results in comparison to post-transfusion increase (PTI) and corrected count increment (CCI).BACKGROUNDPathogen inactivation (PI) techniques for platelet concentrates (PCs) are one of the latest innovations to improve blood safety and reduce the risk of transfusion-transmitted infections (TTIs). An impaired function and in vivo recovery of platelets as well as an increased PC demand are concerns regarding these techniques. The intent of this study was to evaluate the hemostatic effect of PCs treated with the Intercept™ System by thromboelastometry (TEM) and to assess the clinical validity of its results in comparison to post-transfusion increase (PTI) and corrected count increment (CCI).This prospective-observational study included 47 patients (m:f = 25:22; median age: 54 years [21-70]) of our Bone Marrow Transplantation unit with hemato-oncological malignancies transfused with Intercept™-treated PCs. Serial TEM measurements were performed just before and 1 hour after PC transfusion and were analyzed for their correlation with PTI and CCI as well as for clinical variables.STUDY-DESIGN AND METHODSThis prospective-observational study included 47 patients (m:f = 25:22; median age: 54 years [21-70]) of our Bone Marrow Transplantation unit with hemato-oncological malignancies transfused with Intercept™-treated PCs. Serial TEM measurements were performed just before and 1 hour after PC transfusion and were analyzed for their correlation with PTI and CCI as well as for clinical variables.The majority of our patients had received a hematopoietic stem cell transplantation (HSCT) (n = 41; 87%). In median 9 (1-50) PCs were transfused. Serial TEM, PTI, and CCI measurements were available for 150 transfusion episodes. The median platelet dose transfused was 2.65 × 1011 /unit (1.8-6). The median CCI was 9.250 (0-28.000). We observed a significant improvement in TEM parameters (p < 0.05) after transfusion of PI PCs, which did not mandatory correlate with the 1-hour PTI and CCI.RESULTSThe majority of our patients had received a hematopoietic stem cell transplantation (HSCT) (n = 41; 87%). In median 9 (1-50) PCs were transfused. Serial TEM, PTI, and CCI measurements were available for 150 transfusion episodes. The median platelet dose transfused was 2.65 × 1011 /unit (1.8-6). The median CCI was 9.250 (0-28.000). We observed a significant improvement in TEM parameters (p < 0.05) after transfusion of PI PCs, which did not mandatory correlate with the 1-hour PTI and CCI.Serial TEM measurements indicate the hemostatic effect of Intercept™-treated PCs. The 1-hour PTI and CCI may not appropriately reflect the in vivo function of platelets after PI PC transfusion.CONCLUSIONSerial TEM measurements indicate the hemostatic effect of Intercept™-treated PCs. The 1-hour PTI and CCI may not appropriately reflect the in vivo function of platelets after PI PC transfusion. BACKGROUNDPathogen inactivation (PI) techniques for platelet concentrates (PCs) are one of the latest innovations to improve blood safety and reduce the risk of transfusion‐transmitted infections (TTIs). An impaired function and in vivo recovery of platelets as well as an increased PC demand are concerns regarding these techniques. The intent of this study was to evaluate the hemostatic effect of PCs treated with the Intercept™ System by thromboelastometry (TEM) and to assess the clinical validity of its results in comparison to post‐transfusion increase (PTI) and corrected count increment (CCI).STUDY‐DESIGN AND METHODSThis prospective‐observational study included 47 patients (m:f = 25:22; median age: 54 years [21‐70]) of our Bone Marrow Transplantation unit with hemato‐oncological malignancies transfused with Intercept™‐treated PCs. Serial TEM measurements were performed just before and 1 hour after PC transfusion and were analyzed for their correlation with PTI and CCI as well as for clinical variables.RESULTSThe majority of our patients had received a hematopoietic stem cell transplantation (HSCT) (n = 41; 87%). In median 9 (1‐50) PCs were transfused. Serial TEM, PTI, and CCI measurements were available for 150 transfusion episodes. The median platelet dose transfused was 2.65 × 1011/unit (1.8‐6). The median CCI was 9.250 (0‐28.000). We observed a significant improvement in TEM parameters (p < 0.05) after transfusion of PI PCs, which did not mandatory correlate with the 1‐hour PTI and CCI.CONCLUSIONSerial TEM measurements indicate the hemostatic effect of Intercept™‐treated PCs. The 1‐hour PTI and CCI may not appropriately reflect the in vivo function of platelets after PI PC transfusion. Pathogen inactivation (PI) techniques for platelet concentrates (PCs) are one of the latest innovations to improve blood safety and reduce the risk of transfusion-transmitted infections (TTIs). An impaired function and in vivo recovery of platelets as well as an increased PC demand are concerns regarding these techniques. The intent of this study was to evaluate the hemostatic effect of PCs treated with the Intercept™ System by thromboelastometry (TEM) and to assess the clinical validity of its results in comparison to post-transfusion increase (PTI) and corrected count increment (CCI). This prospective-observational study included 47 patients (m:f = 25:22; median age: 54 years [21-70]) of our Bone Marrow Transplantation unit with hemato-oncological malignancies transfused with Intercept™-treated PCs. Serial TEM measurements were performed just before and 1 hour after PC transfusion and were analyzed for their correlation with PTI and CCI as well as for clinical variables. The majority of our patients had received a hematopoietic stem cell transplantation (HSCT) (n = 41; 87%). In median 9 (1-50) PCs were transfused. Serial TEM, PTI, and CCI measurements were available for 150 transfusion episodes. The median platelet dose transfused was 2.65 × 10 /unit (1.8-6). The median CCI was 9.250 (0-28.000). We observed a significant improvement in TEM parameters (p < 0.05) after transfusion of PI PCs, which did not mandatory correlate with the 1-hour PTI and CCI. Serial TEM measurements indicate the hemostatic effect of Intercept™-treated PCs. The 1-hour PTI and CCI may not appropriately reflect the in vivo function of platelets after PI PC transfusion. BACKGROUND Pathogen inactivation (PI) techniques for platelet concentrates (PCs) are one of the latest innovations to improve blood safety and reduce the risk of transfusion‐transmitted infections (TTIs). An impaired function and in vivo recovery of platelets as well as an increased PC demand are concerns regarding these techniques. The intent of this study was to evaluate the hemostatic effect of PCs treated with the Intercept™ System by thromboelastometry (TEM) and to assess the clinical validity of its results in comparison to post‐transfusion increase (PTI) and corrected count increment (CCI). STUDY‐DESIGN AND METHODS This prospective‐observational study included 47 patients (m:f = 25:22; median age: 54 years [21‐70]) of our Bone Marrow Transplantation unit with hemato‐oncological malignancies transfused with Intercept™‐treated PCs. Serial TEM measurements were performed just before and 1 hour after PC transfusion and were analyzed for their correlation with PTI and CCI as well as for clinical variables. RESULTS The majority of our patients had received a hematopoietic stem cell transplantation (HSCT) (n = 41; 87%). In median 9 (1‐50) PCs were transfused. Serial TEM, PTI, and CCI measurements were available for 150 transfusion episodes. The median platelet dose transfused was 2.65 × 1011/unit (1.8‐6). The median CCI was 9.250 (0‐28.000). We observed a significant improvement in TEM parameters (p < 0.05) after transfusion of PI PCs, which did not mandatory correlate with the 1‐hour PTI and CCI. CONCLUSION Serial TEM measurements indicate the hemostatic effect of Intercept™‐treated PCs. The 1‐hour PTI and CCI may not appropriately reflect the in vivo function of platelets after PI PC transfusion. |
| Author | Rabitsch, Werner Leitner, Gerda C. Wohlfarth, Philipp Tolios, Alexander Ho, Markus Hopfinger, Georg |
| AuthorAffiliation | 1 Department of Blood Group Serology and Transfusion Medicine Medical University of Vienna Vienna Austria 2 Stem Cell Transplantation Unit, Department of Medicine I Medical University of Vienna Vienna Austria |
| AuthorAffiliation_xml | – name: 1 Department of Blood Group Serology and Transfusion Medicine Medical University of Vienna Vienna Austria – name: 2 Stem Cell Transplantation Unit, Department of Medicine I Medical University of Vienna Vienna Austria |
| Author_xml | – sequence: 1 givenname: Gerda C. orcidid: 0000-0001-8298-0740 surname: Leitner fullname: Leitner, Gerda C. email: gerda.leitner@meduniwien.ac.at organization: Medical University of Vienna – sequence: 2 givenname: Markus surname: Ho fullname: Ho, Markus organization: Medical University of Vienna – sequence: 3 givenname: Alexander surname: Tolios fullname: Tolios, Alexander organization: Medical University of Vienna – sequence: 4 givenname: Georg surname: Hopfinger fullname: Hopfinger, Georg organization: Medical University of Vienna – sequence: 5 givenname: Werner surname: Rabitsch fullname: Rabitsch, Werner organization: Medical University of Vienna – sequence: 6 givenname: Philipp surname: Wohlfarth fullname: Wohlfarth, Philipp organization: Medical University of Vienna |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/32319678$$D View this record in MEDLINE/PubMed |
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| Snippet | BACKGROUND
Pathogen inactivation (PI) techniques for platelet concentrates (PCs) are one of the latest innovations to improve blood safety and reduce the risk... Pathogen inactivation (PI) techniques for platelet concentrates (PCs) are one of the latest innovations to improve blood safety and reduce the risk of... BACKGROUNDPathogen inactivation (PI) techniques for platelet concentrates (PCs) are one of the latest innovations to improve blood safety and reduce the risk... |
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| SubjectTerms | Bone marrow Bone marrow transplantation Correlation analysis Deactivation Health risks Hematopoietic stem cells In vivo methods and tests Inactivation Platelets Point of care testing Risk reduction Stem cell transplantation Stem cells Transfusion Transfusion Medicine Transplantation |
| Title | The assessment of platelet function by thromboelastometry as a point‐of‐care test to guide Intercept‐treated platelet support in hemato‐oncological patients and hematopoietic stem cell transplantation recipients |
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