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Prevention of platelet transfusion refractoriness and HLA alloimmunization by leukocyte filtered platelet transfusion: a meta analysis Chinese
Yuan Q, Chen X, Cheng L, Zhou CH, Fu XM, Li YP, Wang NH, Wang L
Chung-Kuo i Hsueh Ko Hsueh Yuan Hsueh Pao [Acta Academiae Medicinae Sinicae]. 2011;33((4):):412-20.
Abstract
Objective: To compare and assess the effectiveness of leukocyte-filtered platelet and standard platelet concentrates transfusion in preventing platelet transfusion refractoriness (PTR) and human leukocyte antigen (HLA)-alloimmunization. Methods: Randomized controlled trials (RCTs) or quasi-RCTs comparing leukocyte-filtered platelet with standard platelet concentrates transfusion (up to December 31 2009) were searched and identified from Medline, EMBASE, The Cochrane Library, and CBM. A meta-analysis was conducted with Cochrane Collaboration's RevMan 5.0. Results: The search identified 558 citations in total, in which 7 articles in English were finally included in the meta-analysis. The analysis showed that compared with standard platelet concentrates transfusion, leukocyte-filtered platelet transfusion signficantly decreased PTR [RR=0.59, 95% CI (0.42, 0.82), P=0.002] and HLA-alloimmunization [RR=0.49, 95% CI (0.33, 0.74), P=0.0006]. Subgroup analysis showed that HLA-alloimmunization was significantly reduced by leukocyte-filtered platelet transfusion among thepatients with acute myelocytic leukemia [RR=0.42, 95% CI (0.32, 0.56), P<0.00001], while no significant difference was detected in patients with acute lymphoblastic leukemia because of the limited sample size [RR=0.5, 95% CI (0.10, 2.41), P=0.39]. Conclusions: The current evidence shows that leukocyte-filtered platelet transfusion can prevent PTR and HLA-alloimmunization more effectively than standard platelet transfusion. Well-designed, large-scale RCTs are still needed to further confirm this finding.