A flow cytometric technique using thiazole orange to detect platelet engraftment following pediatric stem-cell transplants (original) (raw)
Related papers
Vox Sanguinis, 2009
Background and Objective Storage of platelets > 5 days provides improved availability, logistical management and decreased outdating. Promising results on in vitro parameters and on in vivo post-transfusion recovery and survival of autologous platelets in healthy volunteers have earlier been shown. To provide additional verification, randomized patient transfusion studies are needed. Materials and Methods Sixty allogeneic haematopoietic progenitor cell transplant recipients were randomized to receive buffy-coat (BC) platelets stored in platelet additive solution (PAS) for 1-5 days the first time a prophylactic transfusion was needed after transplantation, followed the second time by platelets stored for 6-7 days or vice versa. The corrected count increment (CCI) for 1 and 24 h were calculated. Results CCI 1 h and CCI 24 h were higher for platelets stored 1-5 days as compared to 6-7 days, 10AE4 ± 5AE1 vs. 7AE4 ± 3AE8 (P < 0AE001) and 5AE4 ± 4AE1 vs. 2AE6 ± 2AE6 (P < 0AE001), respectively. Time to next platelet transfusion was significantly longer after a transfusion of platelets stored for 1-5 days as compared to platelets stored for 6-7 days: 2AE2 ± 1AE1 vs. 1AE6 ± 0AE8 days, respectively (P < 0AE005). No differences in bleeding events and no transfusion reaction were recorded. Conclusion The advantage of an extension of platelet storage time beyond day 5 should be balanced against the increased need for platelet transfusions that may occur and the conceivable risk of transfusion failure.
International journal of laboratory hematology, 2015
Engraftment is a critical milestone of the hematopoietic stem cell transplantation (HSCT) process. The immature platelet fraction (IPF) and immature reticulocyte fraction (IRF) are considered early indicators of bone marrow recovery. The objective of this study was to assess these parameters as predictors of HSCT engraftment. Neutrophil and platelet engraftment were defined as the first of three consecutive days with an absolute neutrophil count >0.5 × 10(9) /L or platelet count >20 × 10(9) /L, respectively. The IRF cutoff was 12%. Two IPF cutoffs were used: >6.2% and >10%. The study sample comprised 44 patients, of whom 24 had undergone autologous HSCT and 20 had undergone allogeneic HSCT. Absolute neutrophil counts >0.5 × 10(9) /L were preceded by IRF >12% in 86% of patients (38 of 44). Platelet counts >20 × 10(9) /L were preceded by an IPF >6.2% in 90% of patients (37 of 41) and by an IPF >10% in 63% of patients (26 of 41). The results show that IRF and...
OncoTargets and Therapy, 2012
The immature (or reticulated) platelet fraction (IPF) is rich in nucleic acids, especially RNA, and can be used as a predictive factor for platelet recovery in platelet immunomediated consumption or in postchemotherapy myelosuppression. Our aim was to determine if transfusions with IPF-rich solutions, during autologous peripheral blood stem cell transplantation, reduce the occurrence of bleeding and hemorrhagic complications. Patients and methods: Transfusions were administered to 40 children, affected with hematological pathologies, who underwent autologous peripheral hematopoietic progenitor cell transplantation. There were two groups of 20 patients, one group treated with IPF-poor and the other with IPF-rich solutions. In the two groups, the conditioning regimen was the same for the same pathology (hematological pathologies: 14 acute lymphoblastic leukemia; twelve acute myelocytic leukemia; four non-Hodgkin's lymphoma; two Hodgkin's lymphoma; eight solid tumors). A new automated analyzer was used to quantify the IPF: the XE2100 (Sysmex, Kobe, Japan) blood cell counter with upgraded software. Results: The 20 patients who received solutions with a high percentage of IPF (3%-9% of total number of infused platelets) required fewer transfusions than the 20 patients who received transfusions with a low percentage of IPF (0%-1% of total number of infused platelets): 83 versus 129 (mean of number of transfusions 4.15 versus 6.45) and a significant difference was found between the two groups by using the Mann-Whitney test (P , 0.001). The prophylactic transfusions decreased from three to two per week. There was only one case of massive hemorrhage. Conclusion: The use of IPF solutions reduces the number of transfusions and bleedings after peripheral blood stem cell transplantation in pediatric patients.
Assessment of the correlation of platelet morphology with in vivo recovery and survival
Transfusion, 2005
BACKGROUND: There is continuing interest in the development of in vitro tests evaluating the in vivo function, recovery, and survival of platelets stored for transfusion. A recent forum concluded that no completely reliable test exists, although discoid morphology indicates a platelet's good health. We evaluated a novel device, the NAPSAC (Noninvasive Assessment of Platelet Shape and Concentration), designed to determine noninvasively the proportion of discoid platelets in a stored concentrate, as well as platelet concentration. STUDY DESIGN AND METHODS: Twenty-eight plateletapheresis concentrates stored 24 hours in PL-146 were evaluated. Percent discoid platelet results were correlated with radiolabeled autologous recovery and survival performed using 111Indium oxyquinoline and calculated using linear (L) and multiple-hit (M) models. pH of 8 concentrates was raised at the end of storage with 6N NaOH. Platelet concentration measured by NAPSAC and Coulter Thrombocounter C was compared in 256 plateletapheresis products. RESULTS: Percent discoid platelets at 24 hours did not correlate significantly with platelet recovery or survival (recovery L = 0.29, M = 0.28; survival L = 0.16, M = 0.03). Raising the pH (mean 6.38 to 6.94) resulted in a significant increase in percent discoid platelets (21% to 41%). Platelet concentration values for both methods studied were linearly correlated with a slope of 1.01 ± 0.03, r = 0.81. CONCLUSION: Percent discoid platelets was not predictive of posttransfusion platelet recovery or survival. The results suggest that non-discoid platelets may survive posttransfusion and even revert to discoid shape, since raising the pH approximately doubled the percent of discoid platelets. The NAPSAC was shown to be a reliable instrument for noninvasively determining platelet concentration in PL-146 concentrates.
Bone Marrow Transplantation, 1998
While abundant data exist documenting variables associated with early platelet engraftment after autologous PBPC transplantation, data concerning later sustained platelet engraftment is sparse. We retrospectively examined a series of 80 patients undergoing autologous PBPC transplantation with respect to their platelet count 6 weeks after transplant. Underlying diagnoses included breast cancer (n = 33), non-Hodgkin's lymphoma (n = 32), Hodgkin's disease (n = 9), and other hematologic malignancies (n = 6). Patients received G-CSF for PBPC mobilization and collected a target threshold number of 2.0 × 10 6 CD34 + cells per kilogram. A univariate analysis revealed that a diagnosis of breast cancer, fewer courses of prior chemotherapy, younger age and complete remission were associated with a higher 6-week platelet count. Additionally, the ability to collect the threshold number of CD34 + with fewer sessions of leukapheresis was also associated with a higher 6-week platelet count. The platelet count and the white blood cell count at the initiation of PBPC collection was also associated with a higher 6-week platelet count. A multivariate analysis revealed a higher platelet count on the first day of pheresis, fewer phereses required to collect 2 × 10 6 CD34 + cells per kilogram, and a diagnosis of breast cancer were all associated with a higher 6-week posttransplant platelet count. Seven patients failed to reach a 6-week platelet count of 30 × 10 9 /l and an additional five patients had a platelet count of 30-50 × 10 9 /l. We conclude that underlying clinical characteristics, as well as hematologic variables at the time of PBPC collection, influence later, sustained platelet engraftment. A percentage of patients have poor sustained platelet engraftment and may be candidates for new cytokines that specifically target megakaryocyte growth and development.
Immature Platelet Fraction as a Thrombopoietic Index in Donor ’ s Plateletpheresis
2018
The purpose of this study was to examine the activity of thrombocytopoiesis in repeat donating platelets for the preparation of platelet concentrates (PC).The work was based on a retrospective analysis of databases. Donors undergoing plateletpheresis by differential centrifugation for the first time (Group 2, n= 24) and repeat donors donating both by differential centrifugation (Group 3, n= 44) and by apheresis (Group 4, n= 121) every other week for 2–5 years were compared to healthy volunteers (Group 1, n= 87). The platelet count (PLTs), percentage of immature platelets fraction (IPF%) and their absolute values (A-IPF) was performed with the automated analyzer Sysmex XE-2100 (Sysmex, Cobe, Japan). The parameter IPF was chosen by us as a thrombopoietic index. There was not a significant difference in the PLTs for donors before the procedures and the control. Using the IPF obtained in Group 1 we found a significantly higher level in the donor’s blood before the collection of the seco...
Pan African Medical Journal
Introduction: For many years, platelet concentrates have been used for the prevention as well as treatment of bleeding disorders, especially in those patients with haematological problems involving platelet disorders as well as refractoriness, In addition, platelet concentrates (PCs) have been widely used to support patients undergoing bone marrow transplantation or who are receiving myelotoxic treatments. The aim of this study was to determine the quality of platelet concentrates by assessing platelet counts, volume, pH changes, swirling, residue of the red blood cells and white blood cell counts. Assess the in vivo viability of a transfused platelet product using the corrected count increment (CCI) and the percentage platelets response (PPR). This descriptive analysis study was done in Kenyatta National Hospital Blood Transfusion Unit between July 2016 and December 2016. Methods: The in vitro Platelets concentrates quality was accurately determined and assessed using certain parameters. Platelet concentrates in ethylene diamine tetra acetic acid (EDTA) was used for analysis using Cell-Dyn 3700 analyser. The volume of PCs used was an average of 2mls of PCs, the pH was measured using digitalised Hanna edge pH kit. Agitation was done using Helmer agitator and centrifugation was done using Roto silenta 630 RS centrifuge. The in vivo viability of a transfused product was determined using corrected count increment (CCI) and percentage recovery (PR) between 1 and 20-hour after transfusion. Pre and post-transfused whole blood in EDTA collected from the recipients was analysed to access the functional platelets in the circulation. Data analysis was done using SPSS. Results: A total of 384 platelet concentrates were analysed and used in transfusion. The majority 96, (40%) were O Rhesus D+ and the least being AB Rhesus D-at (1%).Centrifugation, separation and agitation was done according to standard procedure (n=384). Only (246 (65%) of the concentrates were found fit for use out of a total of (n=384) leaving 138 (35%) which did not meet the KNH/KNBTS criteria. The minimum specifications for platelet count are 5.5 x (10 9). The duration of 3 days of storage on average, the WBC count (10 9) was Mean ± SD 4.50 ± 3.50. Using the Hanna edge pH kit the pH Mean was ±SD 7.18 ± 8.82 and the used Volume (Mls) was at 55 ± 15. The concentrate was issued within 3 days of processing. After transfusion, the percentage platelet response (PPR) was 72% in male recipients at 1-hour and 30% at 20-hours while 69% in female recipients at 1-hour and 25% at 20-hours. The invivo viability of platelet product had a corrected count increment (CCI) of 75% ≥ 7500 at 1-hour and CCI of18% ≥ 30% at 20-hours in male recipients. In the same study, the female recipients had a CCI of 80% ≥ 7500 at 1-hour and a CCI of 25% ≥ 30% at 20-hours. Conclusion: The findings on platelets concentrates quality 65% met platelets transfusion criteria while 35% did not. On preparation of platelets concentrates there was high counts of white blood cells 4.5±3.5×10 9 than recommended counts by Kenya National Blood Transfusion Services < 0.83×10 9. Both percentage platelet response (PPR) and corrected count increment (CCI) were very low at 20 hours compared to British committee for standards haematology criteria for successful increment of platelet products (PPR ≥ 30% and CCI ≥ 7500). Apheresis platelets transfusion can be introduced at KNH and use of leukoreduction performed on the platelet concentrates which are prepared within the Hospital. With such rate of refractoriness, additional tests to confirm the real cause of unviability of platelets in the patients need to be performed. Recipients should be done evaluation of the pattern of refractoriness followed by HLA compatibility testing. In addition, if there is a high, compatible cross-matched, selected apheresis platelet concentrate pint should be transfused. This unviability was due to recipients with either immune-mediated refractoriness or non-immune mediated refractoriness.