Evaluation of platelet count response following single-donor thrombopheresis transfusion
DOI:
https://doi.org/10.58524/93zb1x98Keywords:
Blood transfusion, Corrected count increment, Refractory, Thrombopheresis, PlateletsAbstract
Blood transfusion involves transferring blood or its components from a donor to a recipient, with thrombopheresis or single-donor platelet (SDP) transfusion being one of its key forms. Although generally safe, platelet transfusion carries risks, including immune and non-immune refractoriness and mild reactions. This study aimed to evaluate platelet count responses following single-dose thrombopheresis transfusion. A retrospective analysis was conducted using data from 42 patients who received 115 thrombopheresis units at Mayapada Hospital Tangerang between January 2019 and September 2020. The mean platelet increment was 16.9×10³/μL, and the mean corrected count increment (CCI) was 10.8×10³/μL. Based on CCI evaluation, 74% of patients showed a successful transfusion response, while 26% experienced platelet refractoriness. A 0.9% transfusion reaction rate was observed, manifesting as a single case of urticaria. Statistical analysis showed no significant differences in response among different disease groups (p > 0.05). These findings indicate that single-dose thrombopheresis is generally effective in improving platelet counts and is associated with a very low incidence of adverse reactions. However, the occurrence of refractoriness underscores the importance of identifying contributing factors, particularly immunologic mechanisms, to enhance transfusion outcomes and patient safety.
References
[1] Ritchie NK. Hematologi Dasar Tentang Transfusi Darah. Jakarta (ID): Paramedis Teknologi Transfusi Darah; 2011.
[2] Sundaryono A, Asli A. Penggunaan Batang Tanaman Betadin (Jatropha multifida Linn) untuk Meningkatkan Jumlah Trombosit pada Mus musculus. Media Medika Indonesiana. 2011.
[3] Grondahl G. An Introduction in Veterinary Hematology. 4th ed. Stockholm (SE): Boule Medical AB; 2005. p. 26–7.
[4] Hoffrand A, Pettit J. Kapita Selekta Hematologi. 4th ed. Jakarta (ID): EGC; 2005.
[5] Hulin L. Pathophysiology of Blood and Hematologic System. 1995. p. 69–70.
[6] American Association of Blood Banking (AABB). Blood Component Preparation and Processing. In: AABB Technical Manual. 17th ed. New York (US): AABB Publishing; 2011. p. 198.
[7] Dewi S. Peningkatan jumlah trombosit setelah pemberian transfusi trombosit apheresis pada anak dengan penyakit keganasan disertai trombositopenia refrakter. Simdos Unud. 2016 [cited 2020 Nov 20]. Available from: https://simdos.unud.ac.id/uploads/file_penelitian_1_dir/f7d49d142e7994f4c3eb089d62093989.pdf
[8] Cable R, Carlson B, Kolins J, et al. Practice Guidelines for Blood Transfusion. 2nd ed. 2007.
[9] Banta H, Behney CJ, Langenbrunner JC, et al. Health Technology Case Study 23: The Safety, Efficacy, and Cost Effectiveness of Therapeutic Apheresis. Washington (US): U.S. Government Printing Office; 1983.
[10] New Zealand Blood Service (NZBS). Did you know? 10 historical facts about blood transfusion. NZ Blood Service [Internet]. 2015 [cited 2019 Sep 30]. Available from: https://www.nzblood.co.nz/news/2015/did-you-know-10-historical-facts-about-blood-transfusion/
[11] Kementerian Kesehatan Republik Indonesia. Peraturan Menteri Kesehatan Republik Indonesia Nomor 91 Tahun 2015 tentang Standar Pelayanan Darah. Jakarta (ID): Kementerian Kesehatan RI; 2015.
[12] Barbosa M, Silva K, Coelho D. Risk factors associated with the occurrence of adverse events in plateletpheresis donation. Rev Bras Hematol Hemoter. 2014;36(3):191–5.
[13] Gurkan E, Patah PA, Saliba RM, et al. Efficacy of prophylactic transfusions using single donor apheresis platelets versus pooled platelet concentrates in AML/MDS patients receiving allogeneic transplants. Bone Marrow Transplant. 2007;39(10):601–5.
[14] Singh RP, Marwaha N, Malhotra P, et al. Therapeutic efficacy of different types of platelet concentrates in thrombocytopenic patients. Indian J Hematol Blood Transfus. 2008;24(1):16–22.
[15] Miller Y, Bachowski G, Benjamin R. Practice Guidelines for Blood Transfusion: A Compilation from Recent Peer-Reviewed Literature. Washington (US): American Red Cross; 2007.
[16] Liumbruno G, Bennardello F, Lattanzio A, et al. Recommendations for the transfusion of plasma and platelets. Blood Transfus. 2009;7(2):132–50.
[17] Purba J, Mulatsih S, Nurani N, et al. Faktor risiko refrakter trombosit pada anak. Sari Pediatri. 2013;15:190–4.
[18] Slichter SJ. Evidence-based platelet transfusion guidelines. Hematology Am Soc Hematol Educ Program. 2007;1:172–8.
[19] Nydam T, Kashuk JL. Refractory postinjury thrombocytopenia is associated with multiple organ failure and adverse outcomes. J Trauma Acute Care Surg. 2011;70:401–7.
[20] Kurz M, Greinix H, Hocker P, et al. Specificities of anti-platelet antibodies in multitransfused patients with haematologic disorders. Br J Haematol. 1996;95(3):564–9.
[21] Chaffin DJ. Transfusion reactions: scope of the problem. BBGuy.org [Internet]. 2012 [cited 2020 Nov 20]. Available from: https://www.bbguy.org
[22] Kiswari R. Hematologi dan Transfusi. Semarang (ID): Erlangga; 2014.
[23] Puspita P. Platelets count increment after single donor apheresis in Hasan Sadikin Hospital. Vox Sang [Internet]. 2011 [cited 2020 Nov 20]. Available from: https://scholar.google.co.id/scholar?hl=id&as_sdt=0%2C5&q=platelet+count+increment+puspita
[24] Kementerian Kesehatan Republik Indonesia. Data dan Informasi: Profil Kesehatan Indonesia 2017. Jakarta (ID): Kemenkes RI; 2017.
[25] Klug W, Cummings M. Concepts of Genetics. 4th ed. New York (US): Macmillan; 1994.
[26] Chester M, Olsson M. The ABO blood group gene: a locus of considerable genetic diversity. Transfus Med Rev. 2001;15(3):177–200.
[27] Nester T, Aubuchon J. Hemotherapy decisions and their outcomes. In: AABB Technical Manual. 17th ed. Bethesda (US): AABB; 2011.
[28] Suparto S, Febyan F. Sepsis dan tata laksana berdasar guideline terbaru. Repository Ukrida [Internet]. 2018 [cited 2020 Dec 2]. Available from: http://repository.ukrida.ac.id/bitstream/123456789/403/1/peer%20sepsis.pdf
[29] Bakta M, Suastika K. Gawat darurat di bidang penyakit dalam. Repo Stikes Perintis [Internet]. 2020 [cited 2020 Dec 2]. Available from: http://repo.stikesperintis.ac.id/id/eprint/1079
[30] Cines DB, Bussel J, Liebman H, et al. Guidelines for the investigation and management of idiopathic thrombocytopenic purpura in adults, children, and in pregnancy. Blood. 2003;113(26):531–42.
[31] Shim YJ, Kim UH, Suh JK, et al. Natural course of childhood chronic immune thrombocytopenia using the revised terminology and definitions of the international working group. Blood Res. 2014;49:187–91.
[32] Dickinson H. The causes of childhood leukaemia. BMJ. 2005;330:1279–80.
[33] Grigoropoulos NF, Petter R, Scott M, et al. Leukaemia update. Part 1: diagnosis and management. BMJ. 2013;346:f1660.
[34] Terwilliger T, Hay MA. Acute lymphoblastic leukemia: a comprehensive review and 2017 update. Blood Cancer J. 2017;7:e577.
[35] Liebman H. Thrombocytopenia in cancer patients. Thromb Res. 2014;133:S63–9.
[36] Novotny VMJ. Prevention and management of platelet transfusion refractoriness. Vox Sang. 1999;76(1):1–13.
[37] Shastry S, Chaudhary R. Clinical factors influencing corrected count increment. Transfus Apher Sci. 2012;47(3):327–30.
[38] Prawita A, Mulyantari N, Herawati S. The description of corrected count increment on one hour and 24 hours after platelet apheresis transfusion in Sanglah General Hospital Denpasar. Bali Med J. 2019;8:1391–8.
[39] Jaime-Pérez JC, Fernández LT, Cantú-Rodríguez OG, et al. Platelet survival in hematology patients assessed by the corrected count increment and other formulas. Am J Clin Pathol. 2018;150(3):267–72.
[40] Slichter SJ, Davis K, Enright H, et al. Factors affecting posttransfusion platelet increments, platelet refractoriness, and platelet transfusion intervals in thrombocytopenic patients. Blood. 2005;105(10):4106–14.
[41] Holbro A, Infanti L, Sigle J, et al. Platelet transfusion: basic aspects. Swiss Med Wkly. 2013;143:w13885.
[42] Neunert C, Lim W, Crowther M, et al. Evidence-based practice guideline for immune thrombocytopenia. Blood. 2011;117(16):4190–207.
[43] Petz LD, Garratty G, Calhoun L, et al. Selecting donors of platelets for refractory patients on the basis of HLA antibody specificity. Transfusion. 2000;40(12):1446–56.
[44] Alcorta I, Pereira A, Ordinas A. Clinical and laboratory factors associated with platelet transfusion refractoriness: a case-control study. Br J Haematol. 1996;93(1):220–4.
[45] World Health Organization (WHO). Platelet Transfusion in Clinical Practice: Professional Guidance Document. Geneva (CH): WHO; 2012.
[46] Savage WJ, Savage JH, Tobian AA, et al. Allergic agonists in apheresis platelet products are associated with allergic transfusion reactions. Transfusion. 2012;52(3):575–81.
[47] Chandrashekar L, Rajappa M, Sundar I, et al. Platelet activation in chronic urticaria and its correlation with disease severity. Platelets. 2014;25(3):162–5.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Fajar Nugroho, Atmadi Atmadi, Cornelia Victoria Anghel (Author)
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
