Results of clinical application of pathogen-reduced red blood cell suspension in children with oncological and hematological diseases

Abstract

The problem of blood-borne infections remains relevant in transfusion medicine. Pathogen reduction technologies (PRT) provide a preventive approach to a wide range of transfusion-transmitted infectious diseases. To date, PRT widely used for a number of blood components, however, the use of these technologies for the treatment of erythrocyte-containing components has not been studied. Objective: to conduct a comparative analysis of the clinical efficacy of transfusions of pathogen-reduced and gamma-irradiated erythrocyte suspension in pediatric patients with various oncological and hematological diseases. Seventy transfusions of red blood cell suspensions (RBC-S) (35 transfusions of pathogen-reduced RBC-S and 35 transfusions of gammairradiated RBC-S) in pediatric patients with oncological and hematological diseases were analized. Clinical efficacy parameters such as the hemoglobin and the hematocrit increment after transfusion, the interval between transfusions, the frequency and severity of transfusion reactions were estimated. We also evaluated the correlation between the hemoglobin and the hematocrit increment with age, patient’s body weight, the hemoglobin concentration and patient's hematocrit before transfusion, the volume of transfusion, the hemoglobin dose and the adjusted hemoglobin dose received for transfusion. We found that the clinical efficacy and safety of RBC-Ss of the compared groups did not differ: the hematocrit and the hemoglobin increment, the frequency and severity of transfusion reactions, and the interval between transfusions were comparable between groups. There was no evidence of immune elimination and allo-sensibilization caused by pathogen-reduced RBC-S. In the group of patients receiving pathogen-reduced RBC-S, a correlation was found between the increase in the hemoglobin and hematocrit values with some of the EV indices. According to our data, the spectrum of efficiency and safety indicators of pathogen-reduced RBC-S is no worse than that of gamma-irradiated RBC-S, provided that RBC-S is used for 14 days of storage.