@article{Kanzler2017,
title = {Microparticle detection to guide platelet management for the reduction of platelet refractoriness in children – A study proposal},
author = {Kanzler, Peter et al.},
url = {http://www.trasci.com/article/S1473-0502(16)30202-6/fulltext},
doi = {10.1016/j.transci.2016.12.016},
year = {2017},
date = {2017-02-01},
journal = {Transfusion and Apheresis Science},
volume = {56},
number = {1},
pages = {39-44},
abstract = {Microparticles have been shown to shed from a variety of viable cells as a consequence of inflammatory processes, activation or physical stress. Seventy to 90% of circulating microparticles are thought to be platelet-derived. The content of microparticles in blood collected from normal blood donors is highly variable and transfers into the final blood component. Elevated microparticle content (MPC) in donor blood might indicate an asymptomatic clinical condition of the donor which might affect the transfusion recipient, particularly pediatric patients. ThromboLUX is a new technology designed to routinely test biological samples for microparticle content. We compared MPC in platelet-rich plasma (PRP) of apheresis donors and the corresponding INTERCEPT-treated apheresis products (N = 24). The MPCs in donor and product samples were correlated (r = 0.74, P < 0.001). Microparticles were significantly reduced after plasma replacement and INTERCEPT treatment. These findings are supported by phase contrast microscopy. Platelet transfusions given to patients with fever or systemic inflammation are less efficacious. In addition, transfusing heterogeneous platelets – concentrates with high MPC and activated platelets – to patients whose immune systems are activated might tip them over a threshold and cause platelet refractoriness. Restricting prophylactic platelet transfusions to homogeneous products – concentrates with resting platelets and therefore low MPC – may reduce the risk of refractoriness in cancer patients, especially children with immature immunity. To test this hypothesis we introduce an evaluation protocol for platelet management, i.e., keeping a split inventory of homogeneous and heterogeneous platelets, and using only homogeneous platelets for prophylaxis as a strategy to reduce refractoriness.},
keywords = {Microparticle, Platelet Refractoriness},
pubstate = {published},
tppubtype = {article}
}

@article{Maurer-Spurej2009,
title = {Platelet quality measured with dynamic light scattering correlates with transfusion outcome in hematologic malignancies.},
author = {Maurer-Spurej, E., Labrie, A., Pittendreigh, C., Chipperfield, K., Smith, C., Heddle, N., Liu, Y., Yi, Q.-L. and Barnett, M.},
url = {http://onlinelibrary.wiley.com/wol1/doi/10.1111/j.1537-2995.2009.02302.x/full},
doi = {10.1111/j.1537-2995.2009.02302.x},
year = {2009},
date = {2009-10-22},
journal = {Transfusion},
volume = {49},
number = {11},
pages = {2276-2284},
abstract = {BACKGROUND: A clinically meaningful test for platelet (PLT) quality could improve the transfusion management of patients. The aim of this pilot study was to determine whether a new measure of PLT quality and function based on dynamic light scattering (DLS) correlates with transfusion outcome.

STUDY DESIGN AND METHODS: For a total of 160 transfusions, the pretransfusion, 1 hour posttransfusion, and 24-hour posttransfusion PLT counts were routinely measured in 49 patients (31 male, 18 female; age 46 ± 15 years) with hematologic malignancies. The corrected count increments (CCIs) at 1 hour (PLT recovery) and 24 hours (PLT survival) were calculated and used as the transfusion outcome measures. The ThromboLUX score (LightIntegra Technology, Inc., Vancouver, BC, Canada; range, 0-40; cutoff, 12) and the PLT morphology score of the PLT concentrates were determined and compared to transfusion outcome.

RESULTS: The CCIs and ThromboLUX scores were normally distributed and showed a strong correlation (n = 96, in the mixed regression model the adjusted coefficient is R = 0.6292, p < 0.0001), while other variables such as product type, age, and microscopic PLT morphology score were not correlated with transfusion outcome (p > 0.05). Importantly, 12 of 96 transfusions with poor PLT quality were clinically ineffective, that is, did not adequately increase the PLT counts in the recipients. One patient died after receiving three consecutive ineffective PLT transfusions with a low ThromboLUX score.

CONCLUSION: In this pilot study, the ThromboLUX score strongly correlated with transfusion outcome (PLT recovery and survival) independent of clinical and product issues.},
keywords = {dynamic light scattering, Platelet Activation Status, Platelet Refractoriness},
pubstate = {published},
tppubtype = {article}
}