Platelets photochemically treated with amotosalen HCl and ultraviolet A light correct prolonged bleeding times in patients with thrombocytopenia.

Abstract

BACKGROUND:

Photochemical treatment (PCT) with amotosalen HCl with ultraviolet A illumination inactivates pathogens and white blood cells in platelet (PLT) concentrates.

STUDY DESIGN AND METHODS:

In a Phase II crossover study, 32 patients with thrombocytopenia received one transfusion of PCT and/or one transfusion of untreated (reference) apheresis PLTs. Hemostatic efficacy was assessed with the cutaneous template bleeding time and clinical observations.

RESULTS:

Paired bleeding time data for PCT and reference transfusions were available for 10 patients. Mean pretransfusion bleeding times were 29.2 +/- 1.6 minutes in the PCT group and 28.7 +/- 2.5 minutes in the reference group. After transfusion of a dose of PLTs of at least 6.0 x 10(11), mean 1-hour posttransfusion template bleeding times corrected to 19.3 +/- 9.5 minutes in the PCT group and 14.3 +/- 6.5 minutes in the reference group (p = 0.25). In 29 patients receiving paired PCT and reference transfusions, mean 1-hour posttransfusion PLT count increments were 41.9 x 10(9) +/- 20.8 x 10(9) and 52.3 x 10(9) +/- 18.3 x 10(9) per L for PCT and reference, respectively (p = 0.007), and mean 1-hour posttransfusion PLT corrected count increments (CCIs) were 10.4 x 10(3) +/- 4.9 x 10(3) and 13.6 x 10(3) +/- 4.3 x 10(3) for PCT and reference, respectively (p < 0.001). The time to next PLT transfusion was 2.9 +/- 1.2 days after PCT transfusions versus 3.4 +/- 1.3 days after reference transfusions (p = 0.18). Clinical hemostasis was not significantly different after PCT and reference transfusions.

CONCLUSION:

PCT PLTs provided correction of prolonged bleeding times and transfusion intervals not significantly different than reference PLTs despite significantly lower PLT count increments and CCIs.

• Authors: Sherrill J Slichter, Thomas J Raife, Kathryn Davis, Margaret Rheinschmidt, Donald H Buchholz, Laurence Corash, Maureen G Conlan
• Journal: Transfusion (Transfusion) Vol. 46 Issue 5 Pg. 731-40 (May 2006) ISSN: 0041-1132 [Print] United States
• PMID: 16686840 (Publication Type: Clinical Trial, Phase II, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Furocoumarins
• Photosensitizing Agents
• amotosalen

Topics

• Adolescent
• Adult
• Bleeding Time
• Blood Platelets (drug effects, radiation effects)
• Bone Marrow Transplantation
• Furocoumarins (pharmacology)
• Hematologic Neoplasms (complications, therapy)
• Hemorrhage (etiology, prevention & control)
• Hemostasis (drug effects, radiation effects)
• Humans
• Male
• Middle Aged
• Peripheral Blood Stem Cell Transplantation
• Photosensitizing Agents (pharmacology)
• Platelet Transfusion
• Plateletpheresis
• Thrombocytopenia (etiology, therapy)
• Time Factors
• Ultraviolet Rays