Biomarkers of Complement and Platelet Activation are not correlated with the One or Twenty-Four Hours Corrected Count Increments in Prophylactically Platelet Transfused Hematological Patients: a Prospective Cohort Study

• Published in: Platelets (Edinburgh) Vol. 33; no. 3; pp. 350 - 359
• Main Authors: Åkesson, Alexander, Ljungkvist, Marcus, Martin, Myriam, Blom, Anna M., Klintman, Jenny, Schött, Ulf, Zetterberg, Eva, Kander, Thomas
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 03.04.2022; Taylor & Francis Group
• Subjects: Adult; Aged; Biomarkers - metabolism; Clinical Medicine; Cohort Studies; complement activation; Complement System Proteins - physiology; Female; Hematologi; Hematology; Humans; Klinisk medicin; Male; Medical and Health Sciences; Medicin och hälsovetenskap; Middle Aged; platelet activation; Platelet Activation - physiology; Platelet transfusion; Platelet Transfusion - methods; Prospective Studies; thrombocytopenia; Time Factors; complement activation; Platelet transfusion; thrombocytopenia; platelet activation
• ISSN: 0953-7104; 1369-1635; 1369-1635
• DOI: 10.1080/09537104.2021.1942817

Platelet transfusion refractoriness is a serious clinical concern that complicates the management of thrombocytopenic patients. Previous studies have suggested a potential role for both complement and platelet activation based on in vitro analyses of platelet concentrates. In this study, the post-transfusion platelet response, as indicated by the corrected count increment at 1 and 24 h after prophylactic platelet transfusions, respectively, was correlated with the 1 h post-transfusion Δconcentration (1 h post-transfusion - pretransfusion) of complement and platelet activation biomarkers. The study was registered as a clinical trial at ClinicalTrials.gov (identifier: NCT02601131) and patients were recruited during inpatient care in the hematological department. Soluble terminal complement complexes, soluble P-selectin and soluble CD40 ligand were analyzed. Confirmed alloimmunized patients were excluded. Included subjects were either given platelet transfusions (n = 43) and categorized into four clinical study groups or included in a non-transfused control group (n = 10). In total, 54 transfusions were included. No transfusion-mediated complement activation was observed. The transfusions were associated with a significant increase in the concentration of soluble P-selectin (p < .001), primarily corresponding to the passive infusion of soluble P-selectin-containing plasma residuals. The Δconcentration of soluble P-selectin was, however, not significantly correlated with the corrected count increments. Thus, significant correlations between biomarkers of complement and platelet activation and the post-transfusion platelet response could not be demonstrated in this study.