Summary
The transfusion of red blood cells and platelets is an essential element in the treatment of patients undergoing hematopoietic stem cell transplantation. While blood component therapy has enabled patients to survive the cytopenic period of stem cell therapy, it has been accompanied by the risks and discomforts of transfusion. Although it has been known for almost 30 years that leukocyte depletion is an effective means of preventing many febrile reactions to red blood cell transfusions, only in the last few years has it become apparent that the present technical capability for leukocyte depletion of red blood cell and platelet concentrates affords the opportunity potentially to prevent alloimmunization to HLA antigens and also reduce cytomegalovirus (CMV) transmission as effectively as CMV-seronegative components. Additionally, it is possible that leukocyte depleted components do not cause the immunosuppressive effects noted after allogeneic blood transfusion. Further, there is evidence that there is no clinical disadvantage to providing leukocyte depleted red blood cells and platelets.
There is strong circumstantial evidence that the use of leukocyte depleted red blood cell and platelet components from the time of diagnosis in individuals who may undergo stem cell transplantation and their continued use during transplant therapy is a cost effective strategy for improving patient care.
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Miller, J.P., Mintz, P.D. (1995). Leukocyte Depleted Blood Transfusion in Hematopoietic Stem Cell Reconstitution Therapy. In: Clinical Benefits of Leukodepleted Blood Products. Medical Intelligence Unit. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-26538-3_13
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