Hematology Service, Hospital Universitario, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico.
Hematology. 2024 Dec;29(1):2420144. doi: 10.1080/16078454.2024.2420144. Epub 2024 Oct 28.
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.
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.
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.
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.
These findings support leukoreduction as a primary TA-GVHD preventive measure,along with the advantage in cost reduction.
本研究旨在调查异体造血细胞移植（HCT）患者接受非照射去白细胞血液成分输注后输血相关移植物抗宿主病（TA-GVHD）的发生率。次要目的是描述本中心使用的过滤器对血液制品中白细胞的去除效果。
回顾性分析了 2018 年至 2023 年的临床记录，并前瞻性评估了 2023 年 6 月至 11 月期间血液成分中的残留白细胞，以确认我们的白细胞去除方法的有效性。
共纳入 150 例患者，使用非照射血液制品后未发生 TA-GVHD 病例。3-4 级急性和中重度慢性移植物抗宿主病的发生率分别为 12.7%（n=19）和 2.7%（n=4）。累积死亡率为 39.3%（n=52），总生存率为 3.7 年（95%CI，3.3-4.1 年）。白细胞去除分析显示血小板浓缩物的去除率为 99.93%，红细胞浓缩物的去除率为 99.98%。
HCT 中的 TA-GVHD 一直是一个令人关注的问题，传统上通过血液制品照射来减轻其影响。最近的证据支持白细胞减少技术，这对资源有限的环境尤其有利，对这种需求提出了质疑。
这些发现支持白细胞减少作为 TA-GVHD 的主要预防措施，同时具有降低成本的优势。
