Summary
The use of leukodepleted blood components has grown dramatically in recent years. This growth has been fueled by the demand to minimize risks and optimize the quality of cellular blood components used in transfusion practice. Blood filtration, using high performance filters, is effective in removing significant numbers of donor leukocytes. However, filtration increases the cost of red cell transfusions by 25% and platelet transfusions by 17% over standard blood components. The important issue in determining the cost-effectiveness of leukodepletion is whether any added benefit attributable to a reduced leukocyte load is worth this increased cost.
Recent reports suggest that the use of leukodepleted blood components may be cost-effective in patients with hematologic malignancies who require long-term transfusion support. The precise clinical indications and cost-effectiveness in other patient groups have not been defined. If the preliminary results for hematologic indications are applicable to other diseases, it would appear that wider use of leukodepletion may be both inevitable and desirable.
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References
Lane TA, Anderson KC, Goodnough LT, et al. Leukocyte reduction in blood component therapy. Annals of Internal Medicine 117: 151, 1992.
Perkins HA. Is white cell reduction cost-effective? Transfusion 33: 626, 1993.
Balducci L, Benson K, Lyman GH, et al. Cost-effectiveness of white-cell reduction filters in treatment of adult acute myeloid leukemia. Transfusion 33: 665, 1993.
Blumberg N, Heal J, Rapoport A, et al. Effect of ABO-identical platelets and leukodepletion (LD) on blood utilization and costs of autologous marrow transplantation (BMT). Transfusion 33: A16; 83S, 1993.
Blumberg N, Heal J, Kirkley S, et al. Cost-effectiveness of leukodepleted transfusions during induction therapy for acute leukemia. Transfusion 33: 83S, 1993.
Oksanen K, Elonen E. Impact of leukocyte-depleted blood components on the haematological recovery and prognosis of patients with acute myeloid leukaemia. Br J of Haematol 84: 639, 1993.
Sox HC, Blatt MA, Higgins MC, Marton KI. Medical Decision Making. Boston: Butterworth, 1988.
Finkler SA. The distinction between costs and charges. Annals of Internal Medicine 96: 102, 1982.
Conn RB, ed. Manual for laboratory workload recording method. Chicago: College of American Pathologists, 1989.
Provider Specific file. US Dept of Health and Human Services, Health Care Financing Administration, Office of Statistics and Data Management, Bureau of Data Management and Strategy, Baltimore: 1990.
Schiffer CA. Prevention of alloimmunization against platelets. Blood 77: 1, 1991.
Masse M, Andreu G, Angue M, et al. A multicenter study on the efficiency of white cell reduction by filtration of red cells. Transfusion 31: 792, 1991.
Sniecinski I, O’Donnell MR, Nowicki B, et al. Prevention of refractoriness and HLAalloimmunization using filtered blood products. Blood 71: 1402, 1988.
Rebulla P, Porretti L, Bertolini F, et al. White cell-reduced red cells prepared by filtration: a critical evaluation of current filters and methods for counting residual white cells. Transfusion 33: 128, 1993.
Forbes JM, Anderson MD, Anderson GF, et al. Blood transfusion costs: a multicenter study. Transfusion 31: 318, 1991.
Wallace EL, Surgenor DM, Hao HS, et al. Collection and transfusion of blood components in the United States, 1989. Transfusion 33: 139, 1993.
Hornbrook MC, Dodd RY, Jacobs P, et al. Reducing the incidence of non-A, non-B post-transfusion hepatitis by testing donor blood for alanine aminotransferase. NEJM 307: 1315, 1982.
Eisenstaedt RS, Getzen TE. Screening blood donors for human immunodeficiency virus antibody: cost-benefit analysis. Am J Public Health 78: 450, 1988.
Scitovsky AA, Rice DP. Estimates of the direct and indirect costs of acquired immunodeficiency syndrome in the United States, 1985, 1986, 1991. Public Health Reports 102:5, 1987.
Birkmeyer JD, Goodnough LT, AuBuchon JP, et al.’The cost-effectiveness of preoperative autologous blood donation for total hip and knee replacement. Transfusion 33: 544, 1993.
Dodd RY. The risk of transfusion-transmitted infection. N Engl J Med 327: 419, 1992.
Eernisse JG, Brand A. Prevention of platelet refractoriness due to HLA antibodies by administration of leukocyte-poor blood components. Exp Hematol 9: 77, 1981.
Schiffer CA, Dutcher JP, Aisner J, et al. A randomized trial of leukocyte-depleted platelet transfusion to modify alloimmunization in patients with leukemia. Blood 61: 815, 1983.
Murphy MF, Metcalfe P, Thomas H, et al. Use of leukocyte-poor components and HLA-matched-platelet donors to prevent HLA alloimmunization. Br J Haematol 62: 529, 1986.
Andreu G, Dewailly J, Leberre C, et al. Prevention of HLA immunization with leukocyte-poor packed red cells and platelet concentrates obtained by filtration. Blood 71: 964, 1988.
Saarinen UM, Kekomaki R, Siimes MA et al. Effective prophylaxis against platelet refractoriness in multitransfused patients by use of leukocyte-free blood components. Blood 75: 512, 1990.
van Marwijk Kooy M, van Prooijen HC, Moes M. Use of leukocyte-depleted platelet concentrates for the prevention of refractoriness and primary HLA alloimmunization: A prospective, randomized trial. Blood 77: 201, 1991.
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© 1995 Springer-Verlag Berlin Heidelberg
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Forbes, J.M., Anderson, M.A., Gould, S.A. (1995). Cost-Effectiveness of Leukodepletion. In: Clinical Benefits of Leukodepleted Blood Products. Medical Intelligence Unit. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-26538-3_14
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DOI: https://doi.org/10.1007/978-3-662-26538-3_14
Publisher Name: Springer, Berlin, Heidelberg
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