Juan Pablo Martínez-Hernández, Yesica A López-Mora, Rosario Salazar-Riojas, Dalila Marisol Alvarado Navarro, Ana Karen Hernández-Navarro, Yair Omar Chavez-Estrada, Andrés Gómez-De León, Cesar Homero Gutierrez-Aguirre, Perla R Colunga-Pedraza, Olga Graciela Cantú-Rodríguez, José Carlos Jaime-Pérez, David Gomez-Almaguer
{"title":"重新评估单倍体移植中的血液制品辐照:单中心视角。","authors":"Juan Pablo Martínez-Hernández, Yesica A López-Mora, Rosario Salazar-Riojas, Dalila Marisol Alvarado Navarro, Ana Karen Hernández-Navarro, Yair Omar Chavez-Estrada, Andrés Gómez-De León, Cesar Homero Gutierrez-Aguirre, Perla R Colunga-Pedraza, Olga Graciela Cantú-Rodríguez, José Carlos Jaime-Pérez, David Gomez-Almaguer","doi":"10.1080/16078454.2024.2420144","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>The main objective was to investigate the incidence of transfusion-associated graft-versus-host disease (TA-GVHD) in patients who underwent haploidentical hematopoietic cell transplants (HCT) and received non-irradiated leukoreduced blood components. The secondary objective was to describe our leukodepletion results in blood products obtained by the filters employed at our center.</p><p><strong>Study design and methods: </strong>Clinical records from 2018 to 2023 were retrospectively analyzed, along with a prospective evaluation of residual leukocytes in blood components from June to November 2023 in order to confirm effectivity of our leukodepletion method.</p><p><strong>Results: </strong>150 patients were included, no cases of TA-GVHD were reported after using non-irradiated blood products. The incidence of grade 3-4 acute and moderate-severe chronic GVHD was 12.7% (n = 19) and 2.7% (n = 4), respectively. The cumulative incidence of death was 39.3% (n = 52) with a 3.7-year overall survival (CI 95%, 3.3- 4.1 years). Leukodepletion analysis showed a reduction of 99.93% in platelet concentrates and 99.98% in packed red blood cells.</p><p><strong>Discussion: </strong>TA-GVHD in HCT remains a concern traditionally mitigated using blood product irradiation. Recent evidence obtained in favor of leukoreduction techniques question this need, especially in resource-limited settings.</p><p><strong>Conclusion: </strong>These findings support leukoreduction as a primary TA-GVHD preventive measure,along with the advantage in cost reduction.</p>","PeriodicalId":13161,"journal":{"name":"Hematology","volume":"29 1","pages":"2420144"},"PeriodicalIF":2.0000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Reassessing blood product irradiation in haploidentical transplantation: a single-center perspective.\",\"authors\":\"Juan Pablo Martínez-Hernández, Yesica A López-Mora, Rosario Salazar-Riojas, Dalila Marisol Alvarado Navarro, Ana Karen Hernández-Navarro, Yair Omar Chavez-Estrada, Andrés Gómez-De León, Cesar Homero Gutierrez-Aguirre, Perla R Colunga-Pedraza, Olga Graciela Cantú-Rodríguez, José Carlos Jaime-Pérez, David Gomez-Almaguer\",\"doi\":\"10.1080/16078454.2024.2420144\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>The main objective was to investigate the incidence of transfusion-associated graft-versus-host disease (TA-GVHD) in patients who underwent haploidentical hematopoietic cell transplants (HCT) and received non-irradiated leukoreduced blood components. The secondary objective was to describe our leukodepletion results in blood products obtained by the filters employed at our center.</p><p><strong>Study design and methods: </strong>Clinical records from 2018 to 2023 were retrospectively analyzed, along with a prospective evaluation of residual leukocytes in blood components from June to November 2023 in order to confirm effectivity of our leukodepletion method.</p><p><strong>Results: </strong>150 patients were included, no cases of TA-GVHD were reported after using non-irradiated blood products. The incidence of grade 3-4 acute and moderate-severe chronic GVHD was 12.7% (n = 19) and 2.7% (n = 4), respectively. The cumulative incidence of death was 39.3% (n = 52) with a 3.7-year overall survival (CI 95%, 3.3- 4.1 years). Leukodepletion analysis showed a reduction of 99.93% in platelet concentrates and 99.98% in packed red blood cells.</p><p><strong>Discussion: </strong>TA-GVHD in HCT remains a concern traditionally mitigated using blood product irradiation. Recent evidence obtained in favor of leukoreduction techniques question this need, especially in resource-limited settings.</p><p><strong>Conclusion: </strong>These findings support leukoreduction as a primary TA-GVHD preventive measure,along with the advantage in cost reduction.</p>\",\"PeriodicalId\":13161,\"journal\":{\"name\":\"Hematology\",\"volume\":\"29 1\",\"pages\":\"2420144\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2024-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Hematology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/16078454.2024.2420144\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/10/28 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"HEMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hematology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/16078454.2024.2420144","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/10/28 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"HEMATOLOGY","Score":null,"Total":0}
Reassessing blood product irradiation in haploidentical transplantation: a single-center perspective.
Objectives: The main objective was to investigate the incidence of transfusion-associated graft-versus-host disease (TA-GVHD) in patients who underwent haploidentical hematopoietic cell transplants (HCT) and received non-irradiated leukoreduced blood components. The secondary objective was to describe our leukodepletion results in blood products obtained by the filters employed at our center.
Study design and methods: Clinical records from 2018 to 2023 were retrospectively analyzed, along with a prospective evaluation of residual leukocytes in blood components from June to November 2023 in order to confirm effectivity of our leukodepletion method.
Results: 150 patients were included, no cases of TA-GVHD were reported after using non-irradiated blood products. The incidence of grade 3-4 acute and moderate-severe chronic GVHD was 12.7% (n = 19) and 2.7% (n = 4), respectively. The cumulative incidence of death was 39.3% (n = 52) with a 3.7-year overall survival (CI 95%, 3.3- 4.1 years). Leukodepletion analysis showed a reduction of 99.93% in platelet concentrates and 99.98% in packed red blood cells.
Discussion: TA-GVHD in HCT remains a concern traditionally mitigated using blood product irradiation. Recent evidence obtained in favor of leukoreduction techniques question this need, especially in resource-limited settings.
Conclusion: These findings support leukoreduction as a primary TA-GVHD preventive measure,along with the advantage in cost reduction.
期刊介绍:
Hematology is an international journal publishing original and review articles in the field of general hematology, including oncology, pathology, biology, clinical research and epidemiology. Of the fixed sections, annotations are accepted on any general or scientific field: technical annotations covering current laboratory practice in general hematology, blood transfusion and clinical trials, and current clinical practice reviews the consensus driven areas of care and management.