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Ang AL, Gan LSH, Tuy TT, Ang CH, Tan CW, Tan HH, Shu PH, Zhang Q, Cao Y, Moorakonda RB, Pokharkar Y, Lu J. A randomized cross-over study of cryopreserved platelets in prophylactic transfusions of thrombocytopenic patients. Transfusion 2023; 63:1649-1660. [PMID: 37596937 DOI: 10.1111/trf.17503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/06/2023] [Accepted: 07/08/2023] [Indexed: 08/21/2023]
Abstract
BACKGROUND The short shelf-life of liquid-stored platelets (LP) at 20-24°C poses shortage and wastage challenges. Cryopreserved platelets have significantly extended shelf-life, and were safe and efficacious for therapeutic transfusions of bleeding patients in the Afghanistan conflict and phase 2 randomized studies. Although hematology patients account for half of platelets demand, there is no randomized study on prophylactic cryopreserved platelet transfusions in them. METHODS We performed a phase 1b/2a randomized cross-over study comparing the safety and efficacy of cryopreserved buffy coat-derived pooled platelets (CP) to LP in the prophylactic transfusions of thrombocytopenic hematology patients. RESULTS A total of 18 adults were randomly assigned 1:1 to CP and LP for their first thrombocytopenic period (TP) of up to 28-days. A total of 14 crossed over to the other platelet-arm for the second TP. Overall, 17 subjects received 51 CP and 15 received 52 LP. CP-arm had more treatment emergent adverse event (29.4% vs. 13.3% of subjects, 9.8% vs. 3.8% of transfusions) than LP-arm but all were mild. No thromboembolism was observed. Both arms had similar bleeding rates (23.5% vs. 26.7% of subjects) which were all mild. Subjects in CP-arm had lower average corrected count increments than LP-arm (mean [SD] 5.6 [4.20] vs. 22.6 [9.68] ×109 /L at 1-4 h, p < .001; 5.3 [4.84] vs. 18.2 [9.52] ×109 /L at 18-30 h, p < .001). All TEG parameters at 1-4 h and maximum amplitude (MA) at 18-30 h improved from baseline post-CP transfusion (p < .05) though improvements in K-time and MA were lower than LP (p < .05). DISCUSSION During shortages, CP may supplement LP in prophylactic transfusions of thrombocytopenic patients.
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Affiliation(s)
- Ai Leen Ang
- Department of Hematology, Singapore General Hospital, Singapore
- Blood Services Group, Health Sciences Authority, Singapore
| | | | | | - Chieh Hwee Ang
- Department of Hematology, Singapore General Hospital, Singapore
| | - Chuen Wen Tan
- Department of Hematology, Singapore General Hospital, Singapore
| | - Hwee Huang Tan
- Blood Services Group, Health Sciences Authority, Singapore
| | - Pei Huey Shu
- Blood Services Group, Health Sciences Authority, Singapore
| | | | - Yang Cao
- Singapore Clinical Research Institute, Singapore
| | | | | | - Jia Lu
- DSO National Laboratories, Singapore
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2
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Tynngård N, Bell A, Gryfelt G, Cvetkovic S, Wikman A, Uhlin M, Sandgren P. Cryopreservation of buffy coat derived platelets: Paired in vitro characterization using uncontrolled versus controlled freezing rate protocols. Transfusion 2020; 61:546-556. [PMID: 33345368 PMCID: PMC7898315 DOI: 10.1111/trf.16227] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 09/21/2020] [Accepted: 10/09/2020] [Indexed: 12/21/2022]
Abstract
Background Cryopreserved platelets show a reduced recovery and viability after freezing and thawing including several ultrastructural and phenotypic deteriorations compared with liquid‐stored platelets. It is suggested that using Controlled‐Rate Freezing (CRF) can reduce variability and optimize the functionality profile for cells. The objective of the study is to compare cellular, metabolic, phenotypic and functional effects on platelets after cryopreservation using different freezing rate protocols. Study Design and Methods To evaluate the possible effects of different freezing rate protocols a two‐experimental study comparing diverse combinations was tested with a pool and split design. Uncontrolled freezing of platelets in materials with different thermal conductivity (metal vs cardboard) was evaluated in experiment 1. Experiment 2 evaluated uncontrolled vs a controlled‐rate freezing protocol in metal boxes. All variables were assessed pre and post cryopreservation. Results Directly after thawing, no major differences in platelet recovery, LDH, ATP, Δψ, CD62P, CD42b, platelet endothelial cell adhesion molecule and sCD40L were seen between units frozen with different thermal conductivity for temperature. In contrast, we observed signs of increased activation after freezing using the CRF protocol, reflected by increased cell surface expression of CD62P, PAC‐1 binding and increased concentration of LDH. Agonist induced expression of a conformational epitope on the GPIIb/IIIa complex and contribution to blood coagulation in an experimental rotational thromboelastometry setup were not statistically different between the groups. Conclusion The use of a uncontrolled freezing rate protocol is feasible, creating a platelet product comparable to using a controlled rate freezing equipment during cryopreservation of platelets.
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Affiliation(s)
- Nahreen Tynngård
- Research and Development Unit in Region Östergötland and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Alice Bell
- Department of Laboratory Medicine, Karolinska Institutet, Solna, Sweden
| | - Gunilla Gryfelt
- Department of Clinical Immunology and Transfusion Medicine (KITM), Karolinska University Hospital, Stockholm, Huddinge, Sweden
| | - Stefan Cvetkovic
- Department of Clinical Immunology and Transfusion Medicine (KITM), Karolinska University Hospital, Stockholm, Huddinge, Sweden
| | - Agneta Wikman
- Department of Clinical Immunology and Transfusion Medicine (KITM), Karolinska University Hospital, Stockholm, Huddinge, Sweden.,Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Huddinge, Sweden
| | - Michael Uhlin
- Department of Clinical Immunology and Transfusion Medicine (KITM), Karolinska University Hospital, Stockholm, Huddinge, Sweden.,Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Huddinge, Sweden
| | - Per Sandgren
- Department of Clinical Immunology and Transfusion Medicine (KITM), Karolinska University Hospital, Stockholm, Huddinge, Sweden.,Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Huddinge, Sweden
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3
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Frozen Platelets-Development and Future Directions. Transfus Med Rev 2020; 34:286-293. [PMID: 33317698 DOI: 10.1016/j.tmrv.2020.09.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/10/2020] [Accepted: 09/10/2020] [Indexed: 02/01/2023]
Abstract
Storage requirements and outdating of platelets represent a continued challenge for blood banks. These hurdles are confounded for rural area hospitals or in military deployments. Over 60 years of research and development into frozen platelets have generated a stable and reproducible product. Valeri's method to freeze platelets in 6% dimethyl sulfoxide (DMSO) and storage at -80°C allows for long-term storage alleviating burdens placed on blood banks. Clinical studies show that frozen platelet transfusions are safe with no related thrombotic or other serious adverse events. There are ongoing efforts to demonstrate cryopreserved platelet (CPP) superiority in efficacy studies designed in trauma or cardiac surgery patients. Technical advances in CPP manufacturing including closed system manufacturing, applications of pathogen reduction technology and potency standard characterization add to the appeal of CPP as an alternative to traditional liquid-stored platelets (LP) in settings of supply shortages, mass casualty, active bleeding, rapid provision of HLA-compatible platelets, and remote care.
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4
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Johnson L, Waters L, Green S, Wood B, Marks DC. Freezing expired platelets does not compromise in vitro quality: An opportunity to maximize inventory potential. Transfusion 2019; 60:454-459. [PMID: 31782799 DOI: 10.1111/trf.15616] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 10/30/2019] [Accepted: 11/12/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND OBJECTIVES Cryopreservation provides an option for long-term storage of platelet concentrates. While platelets are usually frozen as soon as practical after collection (within 2 days), the ability to freeze units at a later stage of the shelf life may improve inventory management. As such, the aim of this study was to determine the impact of freezing platelets approaching expiry (Day 5/6). MATERIALS AND METHODS Two ABO-matched buffy coat-derived platelets (30% plasma/70% platelet additive solution) were pooled and split to produce matched pairs (n = 8 pairs). Platelets were frozen on Day 1 after collection (cryopreserved platelets [CPPs]) or Day 5 or 6 (expired-CPPs) at -80°C with 5% to 6% dimethyl sulfoxide. In vitro platelet quality was tested before freezing and after thawing and reconstitution in plasma. RESULTS The majority of prefreeze parameters were equivalent for all platelet units (Day 1 vs. Day 5 or 6). Expired-CPPs had a higher mean postthaw platelet recovery (82 ± 4%) compared to CPPs (75 ± 4%; p = 0.0021). Cryopreservation resulted in a loss of surface glycoproteins (glycoprotein (GP) Ibα, GPIIb, GPVI), an increase in activation markers (phosphatidylserine and P-selectin) and microparticle release, compared to unfrozen platelets. However, the cryopreservation-induced changes were equivalent in CPPs and expired-CPPs. Functionality was measured by thromboelastography and was similar between expired-CPPs (R-time: 5.3 ± 0.3) and CPPs (R-time: 5.4 ± 0.5; p = 0.7094). CONCLUSION The phenotype and functional profile of platelets frozen at expiry were similar to platelets frozen 1 day following collection. These data suggest that expired platelets may represent a suitable starting material for cryopreservation.
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Affiliation(s)
- Lacey Johnson
- Research and Development, Australian Red Cross Blood Service, Sydney, New South Wales, Australia
| | - Lauren Waters
- Research and Development, Australian Red Cross Blood Service, Sydney, New South Wales, Australia
| | - Sarah Green
- Research and Development, Australian Red Cross Blood Service, Sydney, New South Wales, Australia
| | - Ben Wood
- Research and Development, Australian Red Cross Blood Service, Sydney, New South Wales, Australia
| | - Denese C Marks
- Research and Development, Australian Red Cross Blood Service, Sydney, New South Wales, Australia.,Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
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5
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6
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Meinke S, Wikman A, Gryfelt G, Hultenby K, Uhlin M, Höglund P, Sandgren P. Cryopreservation of buffy coat-derived platelet concentrates photochemically treated with amotosalen and UVA light. Transfusion 2018; 58:2657-2668. [PMID: 30281156 DOI: 10.1111/trf.14905] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 07/06/2018] [Accepted: 07/23/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Cryopreserved platelets (CPPs) are considered a promising approach for extended platelet storage, bridging inventory shortages of conventionally stored platelets. It is unknown if platelet concentrates exposed to photochemical treatment (PCT) with amotosalen and ultraviolet A (UVA) light, to inactivate pathogens, are suitable for freezing. The objective of this study was to analyze potential effects of PCT on CPPs as compared with untreated CPPs. STUDY DESIGN AND METHODS A total of 12 PCT-treated and 12 untreated platelet units from buffy coats were cryopreserved at -80°C in 5% dimethyl sulfoxide. CPPs of both types were rapidly thawed at 37°C and resuspended in 200 mL fresh plasma. In vitro properties were analyzed prefreezing, postfreezing and thawing, and on Day 1 after thawing. RESULTS Directly after thawing, no major differences in platelet content, lactase hydrogenase, adenosine triphosphate, mitochondrial membrane potential, CD62P, CD42b, and platelet endothelial cell adhesion molecule were seen between PCT-CPPs and conventional CPPs. Agonist-induced PAC-1 expression and contribution of CPPs to blood coagulation in an experimental rotational thromboelastometry setup were also similar between the groups. On Day 1 after thawing, the CPPs of both types performed less well. The PCT-CPPs tended to be more affected by the freezing process than the conventional CPPs. CONCLUSIONS PCT-CPPs appeared slightly more susceptible to lesion effects by freezing than conventional CPPs, in particular in assays on Day 1 after thawing, but these differences were small relative to the dramatic effects of the freezing process itself.
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Affiliation(s)
- Stephan Meinke
- Department of Medicine Huddinge, Center for Hematology and Regenerative Medicine (HERM), Karolinska Institutet
| | - Agneta Wikman
- Department of Clinical Immunology and Transfusion Medicine (KITM), Karolinska University Hospital.,Department of Laboratory Medicine, Karolinska Institutet
| | - Gunilla Gryfelt
- Department of Clinical Immunology and Transfusion Medicine (KITM), Karolinska University Hospital
| | - Kjell Hultenby
- Division of Clinical Research Center, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Michael Uhlin
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
| | - Petter Höglund
- Department of Medicine Huddinge, Center for Hematology and Regenerative Medicine (HERM), Karolinska Institutet
| | - Per Sandgren
- Department of Clinical Immunology and Transfusion Medicine (KITM), Karolinska University Hospital.,Department of Laboratory Medicine, Karolinska Institutet
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7
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Slichter SJ, Dumont LJ, Cancelas JA, Jones M, Gernsheimer TB, Szczepiorkowski ZM, Dunbar NM, Prakash G, Medlin S, Rugg N, Kinne B, Macdonald VW, Housler G, Valiyaveettil M, Hmel P, Ransom JH. Safety and efficacy of cryopreserved platelets in bleeding patients with thrombocytopenia. Transfusion 2018; 58:2129-2138. [DOI: 10.1111/trf.14780] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Accepted: 03/30/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Sherrill J. Slichter
- Research Institute, Bloodworks Northwest; Seattle Washington
- University of Washington School of Medicine; Seattle Washington
| | - Larry J. Dumont
- Geisel School of Medicine at Dartmouth and Dartmouth-Hitchcock Medical Center; Lebanon New Hampshire
- Blood Systems Research Institute; Denver Colorado
| | - Jose A. Cancelas
- Hoxworth Blood Center; University of Cincinnati; Cincinnati Ohio
| | - MeLinh Jones
- Research Institute, Bloodworks Northwest; Seattle Washington
| | | | | | - Nancy M. Dunbar
- Geisel School of Medicine at Dartmouth and Dartmouth-Hitchcock Medical Center; Lebanon New Hampshire
| | - Gautham Prakash
- Geisel School of Medicine at Dartmouth and Dartmouth-Hitchcock Medical Center; Lebanon New Hampshire
| | - Stephen Medlin
- University of Cincinnati Health Hospital; Cincinnati Ohio
| | - Neeta Rugg
- Hoxworth Blood Center; University of Cincinnati; Cincinnati Ohio
| | - Bridget Kinne
- University of Cincinnati Health Hospital; Cincinnati Ohio
| | | | - Greggory Housler
- U.S. Army Medical Research and Materiel Command; Fort Detrick Maryland
| | | | - Peter Hmel
- Fast-Track Drugs & Biologics, LLC; North Potomac Maryland
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8
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Waters L, Cameron M, Padula MP, Marks DC, Johnson L. Refrigeration, cryopreservation and pathogen inactivation: an updated perspective on platelet storage conditions. Vox Sang 2018; 113:317-328. [PMID: 29441601 DOI: 10.1111/vox.12640] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 11/28/2017] [Accepted: 01/15/2018] [Indexed: 01/08/2023]
Abstract
Conventional storage of platelet concentrates limits their shelf life to between 5 and 7 days due to the risk of bacterial proliferation and the development of the platelet storage lesion. Cold storage and cryopreservation of platelets may facilitate extension of the shelf life to weeks and years, and may also provide the benefit of being more haemostatically effective than conventionally stored platelets. Further, treatment of platelet concentrates with pathogen inactivation systems reduces bacterial contamination and provides a safeguard against the risk of emerging and re-emerging pathogens. While each of these alternative storage techniques is gaining traction individually, little work has been done to examine the effect of combining treatments in an effort to further improve product safety and minimize wastage. This review aims to discuss the benefits of alternative storage techniques and how they may be combined to alleviate the problems associated with conventional platelet storage.
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Affiliation(s)
- L Waters
- Research & Development, Australian Red Cross Blood Service, Alexandria, NSW, Australia.,School of Life Sciences, University of Technology Sydney, Sydney, NSW, Australia
| | - M Cameron
- Research & Development, Australian Red Cross Blood Service, Alexandria, NSW, Australia.,School of Life Sciences, University of Technology Sydney, Sydney, NSW, Australia
| | - M P Padula
- School of Life Sciences, University of Technology Sydney, Sydney, NSW, Australia
| | - D C Marks
- Research & Development, Australian Red Cross Blood Service, Alexandria, NSW, Australia
| | - L Johnson
- Research & Development, Australian Red Cross Blood Service, Alexandria, NSW, Australia
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9
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Ki KK, Johnson L, Faddy HM, Flower RL, Marks DC, Dean MM. Immunomodulatory effect of cryopreserved platelets: altered BDCA3 + dendritic cell maturation and activation in vitro. Transfusion 2017; 57:2878-2887. [PMID: 28921552 DOI: 10.1111/trf.14320] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 07/19/2017] [Accepted: 07/31/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Cryopreservation of platelets (PLTs) is useful in remote areas to overcome logistic problems associated with supply and can extend the shelf life to 2 years. During cryopreservation, properties of PLTs are modified. Whether changes in the cryopreserved PLT (CPP) product are associated with modulation of recipients' immune function is unknown. We aimed to characterize the immune profile of myeloid dendritic cells (mDCs) and the specialized blood DC antigen (BDCA)3+ subset after exposure to CPPs. STUDY DESIGN AND METHODS Using an in vitro whole blood model of transfusion, the effect of CPPs on mDC and BDCA3+ DC surface antigen expression and inflammatory mediator production was examined using flow cytometry. In parallel, polyinosinic:polycytidylic acid (poly(I:C)) or lipopolysaccharide (LPS) was utilized to model processes activated in viral or bacterial infection, respectively. RESULTS Cryopreserved PLTs had minimal impact on mDC responses but significantly modulated BDCA3+ DC responses in vitro. Exposure to CPPs alone up regulated BDCA3+ DC CD86 expression and suppressed interleukin (IL)-8, tumor necrosis factor (TNF)-α, and interferon-γ inducible protein (IP)-10 production. In both models of infection-related processes, exposure to CPPs down regulated BDCA3+ DC expression of CD40, CD80, and CD83 and suppressed BDCA3+ DC production of IL-8, IL-12, and TNF-α. CPPs suppressed CD86 expression in the presence of LPS and IP-10 and IL-6 production with poly(I:C). CONCLUSION Cryopreserved PLTs may be immunosuppressive, and this effect is more evident when processes associated with infection are concurrently activated, especially for BDCA3+ DCs. This suggests that transfusion of CPPs in patients with infection may result in impaired BDCA3+ DC responses.
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Affiliation(s)
- Katrina K Ki
- Research and Development, The Australian Red Cross Blood Service, Brisbane, QLD, Australia.,School of Medicine, The University of Queensland, Brisbane, Brisbane, QLD, Australia
| | - Lacey Johnson
- Research and Development, The Australian Red Cross Blood Service, Sydney, NSW, Australia
| | - Helen M Faddy
- Research and Development, The Australian Red Cross Blood Service, Brisbane, QLD, Australia.,School of Medicine, The University of Queensland, Brisbane, Brisbane, QLD, Australia
| | - Robert L Flower
- Research and Development, The Australian Red Cross Blood Service, Brisbane, QLD, Australia
| | - Denese C Marks
- Research and Development, The Australian Red Cross Blood Service, Sydney, NSW, Australia
| | - Melinda M Dean
- Research and Development, The Australian Red Cross Blood Service, Brisbane, QLD, Australia
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10
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Acker JP, Marks DC, Sheffield WP. Quality Assessment of Established and Emerging Blood Components for Transfusion. JOURNAL OF BLOOD TRANSFUSION 2016; 2016:4860284. [PMID: 28070448 PMCID: PMC5192317 DOI: 10.1155/2016/4860284] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 11/02/2016] [Indexed: 12/16/2022]
Abstract
Blood is donated either as whole blood, with subsequent component processing, or through the use of apheresis devices that extract one or more components and return the rest of the donation to the donor. Blood component therapy supplanted whole blood transfusion in industrialized countries in the middle of the twentieth century and remains the standard of care for the majority of patients receiving a transfusion. Traditionally, blood has been processed into three main blood products: red blood cell concentrates; platelet concentrates; and transfusable plasma. Ensuring that these products are of high quality and that they deliver their intended benefits to patients throughout their shelf-life is a complex task. Further complexity has been added with the development of products stored under nonstandard conditions or subjected to additional manufacturing steps (e.g., cryopreserved platelets, irradiated red cells, and lyophilized plasma). Here we review established and emerging methodologies for assessing blood product quality and address controversies and uncertainties in this thriving and active field of investigation.
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Affiliation(s)
- Jason P. Acker
- Centre for Innovation, Canadian Blood Services, Edmonton, AB, Canada
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada
| | - Denese C. Marks
- Research and Development, Australian Red Cross Blood Service, Sydney, NSW, Australia
| | - William P. Sheffield
- Centre for Innovation, Canadian Blood Services, Hamilton, ON, Canada
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
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11
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Gerber B, Alberio L, Rochat S, Stenner F, Manz MG, Buser A, Schanz U, Stussi G. Safety and efficacy of cryopreserved autologous platelet concentrates in HLA-alloimmunized patients with hematologic malignancies. Transfusion 2016; 56:2426-2437. [PMID: 27339466 DOI: 10.1111/trf.13690] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 04/23/2016] [Accepted: 04/25/2016] [Indexed: 01/19/2023]
Abstract
BACKGROUND Curative chemotherapy approaches in patients with malignancies and platelet (PLT) transfusion refractoriness due to alloimmunization may be hampered by the lack of suitable PLT donors. For these patients, transfusion of cryopreserved autologous PLTs is an option, but is time- and resource-consuming. We aimed at further simplifying this process. STUDY DESIGN AND METHODS A retrospective single-center analysis was conducted on the transfusion of cryopreserved autologous PLTs in nine female alloimmunized, PLT transfusion-refractory patients treated for acute leukemia (n = 8) and non-Hodgkin's lymphoma (n = 1). No additional processing was used before transfusion, and most notably, washing and centrifugation steps were omitted. Clinical efficacy and safety, as well as a flow cytometric assessment of structural and functional PLT changes, were analyzed. RESULTS A total of 40 autologous PLT concentrates were thawed at bedside and transfused a median of 32 (range, 9 to 994) days after cryopreservation. No major bleeds and no severe dimethyl sulfoxide toxicity were observed. The median PLT count increments did not differ 1 and 18 to 24 hours after transfusion and reached 6 × 109 /L (interquartile range [IQR], 3 × 109 -7.5 × 109 /L) and 6 × 109 /L (IQR, 2.5 × 109 -9.5 × 109 /L), respectively. Cryopreservation resulted in partial activation of one-third of the PLTs. In vitro stimulation with strong agonists induced additional full activation of cryopreserved PLTs: median, 55% (IQR, 42%-60%) after thrombin and 39% (IQR, 36%-39%) after convulxin. CONCLUSION The transfusion of cryopreserved autologous PLTs is feasible and safe. Despite the cryopreservation process, PLT functionality is partially maintained.
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Affiliation(s)
- Bernhard Gerber
- Division of Hematology, University and University Hospital Zurich, Zurich, Switzerland. .,Division of Hematology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland.
| | - Lorenzo Alberio
- Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.,Service of Hematology and Central Hematology Laboratory, CHUV, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Sophie Rochat
- Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Frank Stenner
- Department of Medical Oncology, University Hospital Basel, Basel, Switzerland
| | - Markus G Manz
- Division of Hematology, University and University Hospital Zurich, Zurich, Switzerland
| | - Andy Buser
- Department of Haematology, University Hospital Basel, Basel, Switzerland
| | - Urs Schanz
- Division of Hematology, University and University Hospital Zurich, Zurich, Switzerland
| | - Georg Stussi
- Division of Hematology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
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12
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Johnson L, Tan S, Wood B, Davis A, Marks DC. Refrigeration and cryopreservation of platelets differentially affect platelet metabolism and function: a comparison with conventional platelet storage conditions. Transfusion 2016; 56:1807-18. [DOI: 10.1111/trf.13630] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 03/14/2016] [Accepted: 03/20/2016] [Indexed: 01/02/2023]
Affiliation(s)
- Lacey Johnson
- Research and Development; Australian Red Cross Blood Service; Sydney NSW Australia
| | - Shereen Tan
- Research and Development; Australian Red Cross Blood Service; Sydney NSW Australia
| | - Ben Wood
- Research and Development; Australian Red Cross Blood Service; Sydney NSW Australia
- Proteomics Core Facility; University of Technology Sydney; Sydney NSW Australia
| | - April Davis
- Research and Development; Australian Red Cross Blood Service; Sydney NSW Australia
| | - Denese C. Marks
- Research and Development; Australian Red Cross Blood Service; Sydney NSW Australia
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13
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Tegegn TZ, De Paoli SH, Orecna M, Elhelu OK, Woodle SA, Tarandovskiy ID, Ovanesov MV, Simak J. Characterization of procoagulant extracellular vesicles and platelet membrane disintegration in DMSO-cryopreserved platelets. J Extracell Vesicles 2016; 5:30422. [PMID: 27151397 PMCID: PMC4858502 DOI: 10.3402/jev.v5.30422] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 03/18/2016] [Accepted: 03/23/2016] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Freezing is promising for extended platelet (PLT) storage for transfusion. 6% DMSO cryopreserved PLTs (CPPs) are currently in clinical development. CPPs contain significant amount of platelet membrane vesicles (PMVs). PLT-membrane changes and PMV release in CPP are poorly understood, and haemostatic effects of CPP PMVs are not fully elucidated. This study aims to investigate PLT-membrane alterations in CPPs and provide comprehensive characterization of CPP PMVs, and their contribution to procoagulant activity (PCA) of CPPs. METHODS CPPs and corresponding liquid-stored PLTs (LSPs) were characterized by flow cytometry (FC), fluorescence polarization (FP), nanoparticle tracking analysis (NTA), electron microscopy (SEM, TEM), atomic force microscopy (AFM) and thrombin-generation (TG) test. RESULTS SEM and TEM revealed disintegration and vesiculation of the PLT-plasma membrane and loss of intracellular organization in 60% PLTs in CPPs. FP demonstrated that 6% DMSO alone and with freezing-thawing caused marked increase in PLT-membrane fluidity. The FC counts of annexin V-binding PMVs and CD41a(+) PMVs were 68- and 56-folds higher, respectively, in CPPs than in LSPs. The AFM and NTA size distribution of PMVs in CPPs indicated a peak diameter of 100 nm, corresponding to exosome-size vesicles. TG-based PCA of CPPs was 2- and 9-folds higher per PLT and per volume, respectively, compared to LSPs. Differential centrifugation showed that CPP supernatant contributed 26% to CPP TG-PCA, mostly by the exosome-size PMVs and their TG-PCA was phosphatidylserine dependent. CONCLUSIONS Major portion of CPPs does not show activation phenotype but exhibits grape-like membrane disintegration with significant increase of membrane fluidity induced by 6% DMSO alone and further aggravated by freezing-thawing process. DMSO cryopreservation of PLTs is associated with the release of PMVs and marked increase of TG-PCA, as compared to LSPs. Exosome-size PMVs have significant contribution to PCA of CPPs.
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Affiliation(s)
- Tseday Z Tegegn
- Office of Blood Research and Review, Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Silvia H De Paoli
- Office of Blood Research and Review, Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Martina Orecna
- Office of Blood Research and Review, Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Oumsalama K Elhelu
- Office of Blood Research and Review, Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Samuel A Woodle
- Office of Blood Research and Review, Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Ivan D Tarandovskiy
- Office of Blood Research and Review, Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Mikhail V Ovanesov
- Office of Blood Research and Review, Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Jan Simak
- Office of Blood Research and Review, Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA;
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Eker İ, Yılmaz S, Çetinkaya RA, Pekel A, Ünlü A, Gürsel O, Yılmaz S, Avcu F, Muşabak U, Pekoğlu A, Ertaş Z, Açıkel C, Zeybek N, Kürekçi AE, Avcı İY. Generation of Platelet Microparticles after Cryopreservation of Apheresis Platelet Concentrates Contributes to Hemostatic Activity. Turk J Haematol 2016; 34:64-71. [PMID: 27094612 PMCID: PMC5451691 DOI: 10.4274/tjh.2016.0049] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE In the last decade, substantial evidence has accumulated about the use of cryopreserved platelet concentrates, especially in trauma. However, little reference has been made in these studies to the morphological and functional changes of platelets. Recently platelets have been shown to be activated by cryopreservation processes and to undergo procoagulant membrane changes resulting in the generation of platelet-derived microparticles (PMPs), platelet degranulation, and release of platelet-derived growth factors (PDGFs). We assessed the viabilities and the PMP and PDGF levels of cryopreserved platelets, and their relation with thrombin generation. MATERIALS AND METHODS Apheresis platelet concentrates (APCs) from 20 donors were stored for 1 day and cryopreserved with 6% dimethyl sulfoxide. Cryopreserved APCs were kept at -80 °C for 1 day. Thawed APCs (100 mL) were diluted with 20 mL of autologous plasma and specimens were analyzed for viabilities and PMPs by flow cytometry, for thrombin generation by calibrated automated thrombogram, and for PDGFs by enzyme-linked immunosorbent assay testing. RESULTS The mean PMP and PDGF levels in freeze-thawed APCs were significantly higher (2763±399.4/µL vs. 319.9±80.5/µL, p<0.001 and 550.9±73.6 pg/mL vs. 96.5±49 pg/mL, p<0.001, respectively), but the viability rates were significantly lower (68.2±13.7% vs. 94±7.5%, p<.001) than those of fresh APCs. The mean endogenous thrombin potential (ETP) of freeze-thawed APCs was significantly higher than that of the fresh APCs (3406.1±430.4 nM.min vs. 2757.6±485.7 nM.min, p<0.001). Moreover, there was a significant positive poor correlation between ETP levels and PMP levels (r=0.192, p=0.014). CONCLUSION Our results showed that, after cryopreservation, while levels of PMPs were increasing, significantly higher and earlier thrombin formation was occurring in the samples analyzed despite the significant decrease in viability. Considering the damage caused by the freezing process and the scarcity of evidence for their in vivo superiority, frozen platelets should be considered for use in austere environments, reserving fresh platelets for prophylactic use in blood banks.
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Affiliation(s)
| | - Soner Yılmaz
- University of Health Sciences Gülhane Faculty of Medicine, Blood Training Center and Blood Bank, Ankara, Turkey Phone : +90 312 304 4902 E-mail:
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15
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Cid J, Escolar G, Galan A, López‐Vilchez I, Molina P, Díaz‐Ricart M, Lozano M, Dumont LJ. In vitro evaluation of the hemostatic effectiveness of cryopreserved platelets. Transfusion 2015; 56:580-6. [DOI: 10.1111/trf.13371] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 08/17/2015] [Accepted: 08/21/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Joan Cid
- Department of Hemotherapy and HemostasisCDB, IDIBAPS, Hospital Clinic University of BarcelonaBarcelona Spain
| | - Ginés Escolar
- Department of Hemotherapy and HemostasisCDB, IDIBAPS, Hospital Clinic University of BarcelonaBarcelona Spain
| | - Ana Galan
- Department of Hemotherapy and HemostasisCDB, IDIBAPS, Hospital Clinic University of BarcelonaBarcelona Spain
| | - Irene López‐Vilchez
- Department of Hemotherapy and HemostasisCDB, IDIBAPS, Hospital Clinic University of BarcelonaBarcelona Spain
| | - Patricia Molina
- Department of Hemotherapy and HemostasisCDB, IDIBAPS, Hospital Clinic University of BarcelonaBarcelona Spain
| | - Maribel Díaz‐Ricart
- Department of Hemotherapy and HemostasisCDB, IDIBAPS, Hospital Clinic University of BarcelonaBarcelona Spain
| | - Miguel Lozano
- Department of Hemotherapy and HemostasisCDB, IDIBAPS, Hospital Clinic University of BarcelonaBarcelona Spain
| | - Larry J. Dumont
- Center for Transfusion Medicine Research, Department of Pathology the Geisel School of Medicine at DartmouthDartmouth‐Hitchcock Medical Center Lebanon New Hampshire
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16
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Yılmaz S, Çetinkaya RA, Eker İ, Ünlü A, Uyanık M, Tapan S, Pekoğlu A, Pekel A, Erkmen B, Muşabak U, Yılmaz S, Avcı İY, Avcu F, Kürekçi E, Eyigün CP. Freezing of Apheresis Platelet Concentrates in 6% Dimethyl Sulfoxide: The First Preliminary Study in Turkey. Turk J Haematol 2015; 33:28-33. [PMID: 25912150 PMCID: PMC4805338 DOI: 10.4274/tjh.2014.0181] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective: Transfusion of platelet suspensions is an essential part of patient care for certain clinical indications. In this pioneering study in Turkey, we aimed to assess the in vitro hemostatic functions of platelets after cryopreservation. Materials and Methods: Seven units of platelet concentrates were obtained by apheresis. Each apheresis platelet concentrate (APC) was divided into 2 equal volumes and frozen with 6% dimethyl sulfoxide (DMSO). The 14 frozen units of APCs were kept at -80 °C for 1 day. APCs were thawed at 37 °C and diluted either with autologous plasma or 0.9% NaCl. The volume and residual numbers of leukocytes and platelets were tested in both before-freezing and post-thawing periods. Aggregation and thrombin generation tests were used to analyze the in vitro hemostatic functions of platelets. Flow-cytometric analysis was used to assess the presence of frozen treated platelets and their viability. Results: The residual number of leukocytes in both dilution groups was <1x106. The mean platelet recovery rate in the plasma-diluted group (88.1±9.5%) was higher than that in the 0.9% NaCl-diluted group (63±10%). These results were compatible with the European Directorate for the Quality of Medicines quality criteria. Expectedly, there was no aggregation response to platelet aggregation test. The mean thrombin generation potential of post-thaw APCs was higher in the plasma-diluted group (2411 nmol/L per minute) when compared to both the 0.9% NaCl-diluted group (1913 nmol/L per minute) and the before-freezing period (1681 nmol/L per minute). The flow-cytometric analysis results for the viability of APCs after cryopreservation were 94.9% and 96.6% in the plasma and 0.9% NaCl groups, respectively. Conclusion: Cryopreservation of platelets with 6% DMSO and storage at -80 °C increases their shelf life from 7 days to 2 years. Besides the increase in hemostatic functions of platelets, the cryopreservation process also does not affect their viability rates.
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Affiliation(s)
- Soner Yılmaz
- Gülhane Military Medical Academy, Blood Training Center and Blood Bank, Ankara, Turkey. Phone : +90 312 304 49 02 E-mail :
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17
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Johnson L, Reade MC, Hyland RA, Tan S, Marks DC. In vitro comparison of cryopreserved and liquid platelets: potential clinical implications. Transfusion 2014; 55:838-47. [PMID: 25371169 DOI: 10.1111/trf.12915] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 09/02/2014] [Accepted: 09/08/2014] [Indexed: 12/12/2022]
Abstract
BACKGROUND Platelet (PLT) concentrates can be cryopreserved in dimethyl sulfoxide (DMSO) and stored at -80°C for 2 years. These storage conditions improve availability in both rural and military environments. Previous phenotypic and in vitro studies of cryopreserved PLTs are limited by comparison to fresh liquid-stored PLTs, rather than PLTs stored over their clinically relevant shelf life. Further, nothing is known of the effect of reconstituting cryopreserved PLTs in plasma stored at a variety of clinically relevant temperatures. STUDY DESIGN AND METHODS Apheresis PLTs were either stored at room temperature for 5 days or cryopreserved at -80°C with 5% DMSO. Cryopreserved PLTs were thawed at 37°C and reconstituted in plasma (stored at different temperatures) and compared to fresh and expired liquid-stored PLTs. In vitro assays were performed to assess glycoprotein expression, PLT activity, microparticle content, and function. RESULTS Compared to liquid PLTs over storage, cryopreserved PLTs had reduced expression of the key glycoprotein receptors GPIbα and GPIIb. However, the proportion of PLTs expressing activation markers CD62P and CD63 was similar between cryopreserved and liquid-stored PLTs at expiry. Cryopreserved PLT components contained significantly higher numbers of phosphatidylserine- and tissue factor-positive microparticles than liquid-stored PLTs, and these microparticles reduced the time to clot formation and increased thrombin generation. CONCLUSION There are distinct differences between cryopreserved and liquid-stored PLTs. Cryopreserved PLTs also have an enhanced hemostatic activity. Knowledge of these in vitro differences will be essential to understanding the outcomes of a clinical trial comparing cryopreserved PLTs and liquid PLTs stored for various durations.
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Affiliation(s)
- Lacey Johnson
- Research and Development, Australian Red Cross Blood Service, Sydney, NSW, Australia
| | - Michael C Reade
- Burns, Trauma and Critical Care Research Centre, University of Queensland, Brisbane, Queensland, Australia.,Joint Health Command, Australian Defence Force, Canberra, ACT, Australia
| | - Ryan A Hyland
- Research and Development, Australian Red Cross Blood Service, Sydney, NSW, Australia
| | - Shereen Tan
- Research and Development, Australian Red Cross Blood Service, Sydney, NSW, Australia
| | - Denese C Marks
- Research and Development, Australian Red Cross Blood Service, Sydney, NSW, Australia
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18
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Slichter SJ, Jones M, Ransom J, Gettinger I, Jones MK, Christoffel T, Pellham E, Bailey SL, Corson J, Bolgiano D. Review of in vivo studies of dimethyl sulfoxide cryopreserved platelets. Transfus Med Rev 2014; 28:212-25. [PMID: 25439164 DOI: 10.1016/j.tmrv.2014.09.001] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Revised: 09/03/2014] [Accepted: 09/05/2014] [Indexed: 10/24/2022]
Abstract
A literature review was conducted to assess the efficacy and safety of dimethyl sulfoxide (DMSO) cryopreserved platelets for potential military use. In vivo DMSO cryopreserved platelet studies published between 1972 and June of 2013 were reviewed. Assessed were the methods of cryopreservation, posttransfusion platelet responses, prevention or control of bleeding, and adverse events. Using the Department of Defense's preferred 6% DMSO cryopreservation method with centrifugation to remove the DMSO plasma before freezing at -65°C and no postthaw wash, mean radiolabeled platelet recoveries in 32 normal subjects were 33% ± 10% (52% ± 12% of the same subject's fresh platelet recoveries), and survivals were 7.5 ± 1.2 days (89% ± 15% of fresh platelet survivals). Using a variety of methods to freeze autologous platelets from 178 normal subjects, mean radiolabeled platelet recoveries were consistently 39% ± 9%, and survivals, 7.4 ± 1.4 days. More than 3000 cryopreserved platelet transfusions were given to 1334 patients. There were 19 hematology/oncology patient studies, and, in 9, mean 1-hour corrected count increments were 11 100 ± 3600 (range, 5700-15 800) after cryopreserved autologous platelet transfusions. In 5 studies, bleeding times improved after transfusion; in 3, there was either no improvement or a variable response. In 4 studies, there was immediate cessation of bleeding after transfusion; in 3 studies, patients being supported only with cryopreserved platelets had no bleeding. In 1 cardiopulmonary bypass study, cryopreserved platelets resulted in significantly less bleeding vs standard platelets. In 3 trauma studies, cryopreserved platelets were hemostatically effective. No significant adverse events were reported in any study. In summary, cryopreserved platelets have platelet recoveries that are about half of fresh platelets, but survivals are only minimally reduced. The platelets appear hemostatically effective and have no significant adverse events.
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Affiliation(s)
- Sherrill J Slichter
- Puget Sound Blood Center Seattle, WA; University of Washington School of Medicine, Seattle, WA.
| | | | - Janet Ransom
- Fast-Track Drugs & Biologics, LLC, North Potomac, MD
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19
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Johnson L, Coorey CP, Marks DC. The hemostatic activity of cryopreserved platelets is mediated by phosphatidylserine-expressing platelets and platelet microparticles. Transfusion 2014; 54:1917-26. [DOI: 10.1111/trf.12578] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Revised: 12/11/2013] [Accepted: 12/12/2013] [Indexed: 01/03/2023]
Affiliation(s)
- Lacey Johnson
- Research and Development; The Australian Red Cross Blood Service; Sydney NSW Australia
| | - Craig P. Coorey
- Research and Development; The Australian Red Cross Blood Service; Sydney NSW Australia
- Sydney Medical School; University of Sydney; Sydney NSW Australia
| | - Denese C. Marks
- Research and Development; The Australian Red Cross Blood Service; Sydney NSW Australia
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20
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Advances in military, field, and austere transfusion medicine in the last decade. Transfus Apher Sci 2013; 49:380-6. [PMID: 23856530 DOI: 10.1016/j.transci.2013.06.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2013] [Revised: 06/20/2013] [Accepted: 06/21/2013] [Indexed: 11/23/2022]
Abstract
Two decades of war in south-west Asia has demonstrated the essential role of primary resuscitation with blood products in the care of critically injured soldiers. This idea has been widely adopted and is being critically tested in civilian trauma centers. The need for red cells, plasma and platelets to be immediately available in remote locations creates a logistic burden that will best be eased by innovative new blood products such as longer-stored liquid RBCs, freeze-dried plasma, small-volume frozen platelets, and coagulation factor concentrates such as fibrinogen concentrates and prothrombin complex concentrates. Such products have long shelf-lives, low logistic burdens of weight, fragility, or needs for processing prior to use. Developing and fielding a full family of such products will improve field medical care and make products available in the evacuation chain. It also will allow treatment in other austere environments such as the hundreds of small hospitals in the US which serve as Levels 3 and 4 trauma centers but do not currently have thawed plasma or platelets available. Such small trauma centers currently care for half of all the trauma patients in the country. Proving the new generation of blood products work, will help assure their widest availability in emergencies.
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21
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Johnson L, Reid S, Tan S, Vidovic D, Marks DC. PAS-G supports platelet reconstitution after cryopreservation in the absence of plasma. Transfusion 2013; 53:2268-77. [DOI: 10.1111/trf.12084] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Revised: 10/31/2012] [Accepted: 11/16/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Lacey Johnson
- Research and Development; The Australian Red Cross Blood Service; Sydney; Australia
| | - Samantha Reid
- Research and Development; The Australian Red Cross Blood Service; Sydney; Australia
| | - Shereen Tan
- Research and Development; The Australian Red Cross Blood Service; Sydney; Australia
| | - Diana Vidovic
- Research and Development; The Australian Red Cross Blood Service; Sydney; Australia
| | - Denese C. Marks
- Research and Development; The Australian Red Cross Blood Service; Sydney; Australia
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22
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Dumont LJ, Cancelas JA, Dumont DF, Siegel AH, Szczepiorkowski ZM, Rugg N, Pratt PG, Worsham DN, Hartman EL, Dunn SK, O'Leary M, Ransom JH, Michael RA, Macdonald VW. A randomized controlled trial evaluating recovery and survival of 6% dimethyl sulfoxide-frozen autologous platelets in healthy volunteers. Transfusion 2012; 53:128-37. [DOI: 10.1111/j.1537-2995.2012.03735.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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23
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Johnson LN, Winter KM, Reid S, Hartkopf-Theis T, Marks DC. Cryopreservation of buffy-coat-derived platelet concentrates in dimethyl sulfoxide and platelet additive solution. Cryobiology 2011; 62:100-6. [PMID: 21241687 DOI: 10.1016/j.cryobiol.2011.01.003] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2010] [Revised: 01/06/2011] [Accepted: 01/10/2011] [Indexed: 10/18/2022]
Abstract
Platelets prepared in plasma can be frozen in 6% dimethyl sulfoxide (Me(2)SO) and stored for extended periods at -80°C. The aim of this study was to reduce the plasma present in the cryopreserved product, by substituting plasma with platelet additive solution (PAS; SSP+), whilst maintaining in vitro platelet quality. Buffy coat-derived pooled leukoreduced platelet concentrates were frozen in a mixture of SSP+, plasma and 6% Me(2)SO. The platelets were concentrated, to avoid post-thaw washing, and frozen at -80°C. The cryopreserved platelet units (n=9) were rapidly thawed at 37°C, reconstituted in 50% SSP+/plasma and stored at 22°C. Platelet recovery and quality were examined 1 and 24h post-thaw and compared to the pre-freeze samples. Upon thawing, platelet recovery ranged from 60% to 80%. However, there were differences between frozen and liquid-stored platelets, including a reduction in aggregation in response to ADP and collagen; increased CD62P expression; decreased viability; increased apoptosis and some loss of mitochondrial membrane integrity. Some recovery of these parameters was detected at 24h post-thaw, indicating an extended shelf-life may be possible. The data suggests that freezing platelets in 6% Me(2)SO and additive solution produces acceptable in vitro platelet quality.
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Affiliation(s)
- L N Johnson
- Research and Business Development, Australian Red Cross Blood Service, 153 Clarence Street, Sydney, NSW 2000, Australia.
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24
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Lelkens CCM, Koning JG, de Kort B, Floot IBG, Noorman F. Experiences with frozen blood products in the Netherlands military. Transfus Apher Sci 2006; 34:289-98. [PMID: 16815757 DOI: 10.1016/j.transci.2005.11.008] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2005] [Accepted: 11/25/2005] [Indexed: 11/28/2022]
Abstract
For peacekeeping and peace enforcing missions abroad the Netherlands Armed Forces decided to use universal donor frozen blood products in addition to liquid products. This article describes our experiences with the frozen blood inventory, with special attention to quality control. It is shown that all thawed (washed) blood products are in compliance with international regulations and guidelines. By means of the -80 degrees C frozen stock of red cells, plasma and platelets readily available after thaw (and wash), we can now safely reduce shipments and abandon the backup 'walking' blood bank, without compromising the availability of blood products in theatre.
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Affiliation(s)
- C C M Lelkens
- Military Blood Bank, Plesmanlaan 1C, 2333 BZ, Leiden, The Netherlands.
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25
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Nie Y, de Pablo JJ, Palecek SP. Platelet cryopreservation using a trehalose and phosphate formulation. Biotechnol Bioeng 2005; 92:79-90. [PMID: 15937943 DOI: 10.1002/bit.20577] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Long-term storage of platelets is infeasible due to platelet activation at low temperatures. In an effort to address this problem, we evaluated the effectiveness of a formulation combining trehalose and phosphate in protecting platelet structure and function following cryopreservation. An annexin V binding assay was used to quantify the efficacy of the trehalose and phosphate formulation in suppressing platelet activation during cryopreservation. Of the platelets cryopreserved with the trehalose plus phosphate formulation, 23% +/- 1.2% were nonactivated, compared with 9.8% +/- 0.26% nonactivated following cryopreservation with only trehalose. The presence of both trehalose and phosphate in the cryopreservation medium is critical for cell survival and preincubation in trehalose plus phosphate solutions further enhances viability. The effectiveness of trehalose plus phosphate in preserving platelets in a nonactivated state is comparable to 6% dimethyl sulfoxide (Me(2)SO). Measurements of platelet metabolic activity using an alamarBlue assay also established that trehalose plus phosphate is superior to trehalose alone. Finally, platelets protected by the trehalose plus phosphate formulation exhibit similar aggregation response upon thrombin addition as fresh platelets, but an increase of cytosolic calcium concentration upon thrombin addition was not observed in the cryopreserved platelets. These results suggest that trehalose and phosphate protect several aspects of platelet structure and function during cryopreservation, including an intact plasma membrane, metabolic activity, and aggregation in response to thrombin, but not intracellular calcium release in response to thrombin.
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Affiliation(s)
- Ying Nie
- Department of Chemical and Biological Engineering, University of Wisconsin-Madison, 1415 Engineering Drive, Madison, Wisconsin 53706, USA
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26
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Vadhan-Raj S, Kavanagh JJ, Freedman RS, Folloder J, Currie LM, Bueso-Ramos C, Verschraegen CF, Narvios AB, Connor J, Hoots WK, Broemeling LD, Lichtiger B. Safety and efficacy of transfusions of autologous cryopreserved platelets derived from recombinant human thrombopoietin to support chemotherapy-associated severe thrombocytopenia: a randomised cross-over study. Lancet 2002; 359:2145-52. [PMID: 12090979 DOI: 10.1016/s0140-6736(02)09090-6] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND The increasing demand for platelet products, and concern over the transfusion-associated risks of alloimmunisation and infections, have motivated a search for improved methods aimed at keeping exposure to donor antigens to a minimum. Transfusion of thrombopoietin-derived autologous platelets might provide an alternative strategy. We aimed to compare the safety and efficacy of this strategy with that of transfusion with fresh allogeneic platelets in patients with severe chemotherapy-induced thrombocytopenia. METHODS 20 patients with gynaecological malignancies were treated with two doses of 1.2 microg/kg recombinant human thrombopoietin. From day 12, we aimed to collect 50 units of platelets from these patients by plateletpheresis. Harvested platelets were cryopreserved in ThromboSol and 2% dimethyl sulfoxide (DMSO) for use in subsequent autologous transfusions. Patients then received carboplatin for up to six cycles. Patients were randomly assigned to group A (n=10), which received allogeneic fresh platelets at the first instance of severe thrombocytopenia (platelet count <15,000/microL) and then autologous cryopreserved platelets at the next, or to group B (n=10), which received first autologous and then allogeneic platelets. In subsequent cycles, all patients received autologous platelets while available. The primary endpoint was platelet count increment corrected for the number of platelets transfused and the patients' body-surface area. Analysis was by intention to treat. FINDINGS Treatment with recombinant human thrombopoietin significantly increased platelet count (median 2.3-fold [range 1.5-3.3], p<0.0001) in all but one patient in group A. The median number of platelets collected per patient was 53 units (14-66) in two collections (one to three). There was no significant difference in the corrected platelet count increments (CCIs) between the 19 paired transfusions of cryopreserved autologous platelets and fresh allogeneic platelets (median 1-h CCI 15.7 vs 19.8, p=0.398; median 24-h CCI 13.0 vs 18.1, p=0.398). 14 of the 19 patients had a good response (1-h CCI >7.5) to their first transfusion of allogeneic platelets. By contrast, all patients had a good response to their first transfusion of autologous platelets (p=0.063). Moreover, no significant decrease in the CCIs (p=0.405) was seen over six cycles after autologous platelet transfusions (n=63). No transfusion reactions or any serious adverse event was recorded during autologous platelet transfusions. INTERPRETATION Recombinant human thrombopoietin facilitated collection of multiple units of platelets, which could be cryopreserved and reinfused to counteract severe thrombocytopenia during multicycle chemotherapy. Transfusion of autologous cryopreserved platelets derived from recombinant human thrombopoietin can provide a viable strategy to minimise the risks of allogeneic platelet transfusions and provide a long-lasting supply of platelet support.
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Affiliation(s)
- Saroj Vadhan-Raj
- Department of Bioimmunotherapy, University of Texas M D Anderson Cancer Center, Houston, TX 77030, USA.
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27
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Xiao H, Jepkorir CJ, Harvey K, Remick DG. Thrombin-induced platelet microparticles improved the aggregability of cryopreserved platelets. Cryobiology 2002; 44:179-88. [PMID: 12151273 DOI: 10.1016/s0011-2240(02)00024-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Platelets were activated with freezing/thawing and thrombin stimulation, and platelet microparticles generated following platelet activation were isolated with ultracentrifugation. The effects of platelet microparticles on platelet activation were studied with annexin V assay, protein tyrosine phosphorylation, and platelet aggregation. Freezing-induced platelet microparticles decreased but thrombin-induced platelet microparticles increased platelet annexin V binding and aggregation. Freshly washed platelets were cryopreserved using epinephrine and dimethyl sulfoxide (Me(2)SO) as combined cryoprotectants, and stimulated with thrombin-induced platelet microparticles. Following incubation of thrombin-induced platelet microparticles, the reaction time of platelets to agonists decreased but the percentages of aggregation increased, such as washed platelets from 44% +/- 30 to 92% +/- 7, p < 0.001, and cryopreserved platelets from 66% +/- 10 to 77% +/- 7, p < 0.02. By increasing platelet aggregability, platelet microparticles recovered after thrombin stimulation improved platelet function for transfusion. A 53-kDa platelet microparticle protein showed little phosphorylation if it was released from resting platelets or platelets stimulated with ADP, epinephrine, propyl gallate or dephosphorylation if it was derived from ionophore A 23187-stimulated platelets. However, the same protein released from frozen platelets showed significant tyrosine phosphorylation. Since a microparticle protein with 53 kDa was compatible with protein tyrosine phosphatase-1B (PTP-1B), its phosphorylation suggests the inhibition of enzyme activity. The microparticle proteins derived from thrombin-stimulated platelets were significantly phosphorylated at 64 kDa and pp60c-src, suggesting that the activation of tyrosine kinases represents a possible mechanism of thrombin-induced platelet microparticles to improve platelet aggregation.
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Affiliation(s)
- Hongyan Xiao
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI 48109-0602, USA.
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28
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Xiao H, Harvey K, Labarrere CA, Kovacs R. Platelet cryopreservation using a combination of epinephrine and dimethyl sulfoxide as cryoprotectants. Cryobiology 2000; 41:97-105. [PMID: 11034788 DOI: 10.1006/cryo.2000.2271] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Current methods of platelet storage are unsatisfactory because of the short shelf life of platelets and the rapid loss of platelet viability. We have developed a cryopreservation method that results in less damage from freezing and higher recovered function of platelets. Platelets were cryopreserved using a combination of epinephrine (EPN) and dimethyl sulfoxide (Me(2)SO) as cryoprotectants. The response of platelets to agonists was studied by flow cytometry and aggregation tests. Cryopreserving platelets with Me(2)SO decreased platelet annexin V binding due to freezing. The combination of EPN with Me(2)SO enhanced Me(2)SO cryoprotection and decreased platelet microparticle generation, suggesting that cryopreserving platelets using this combination is associated with increased platelet integrity. Platelet cryopreservation with an Me(2)SO/EPN combination also increased platelet aggregability, which was demonstrated by decreasing the lag phase and increasing the aggregation density to 66.39% +/- 6.6 that of fresh platelet-rich plasmas. We conclude that adding EPN as a combined cryoprotectant improves the quality of Me(2)SO-frozen platelets. As a method of aggregation of cryopreserved platelets, this method is comparable to that of normal fresh platelets and may improve the conditions for platelet transfusion.
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Affiliation(s)
- H Xiao
- Methodist Research Institute, 1701 N. Senate Boulevard, Indianapolis, Indiana 46206-1367, USA
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Lozano ML, Rivera J, Corral J, Gonzalez-Conejero R, Vicente V. Platelet cryopreservation using a reduced dimethyl sulfoxide concentration and second-messenger effectors as cryopreserving solution. Cryobiology 1999; 39:1-12. [PMID: 10458897 DOI: 10.1006/cryo.1999.2184] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Cryopreservation of platelets is of great interest since it could extend to years the shelf life of therapeutic platelet concentrates (PCs) and facilitate stockpiling and inventory control in blood banking. We have compared the cryopreservation of PCs by the standard method using 6% Me(2)SO as cryoprotectant with the method of freezing employing low concentrations of Me(2)SO (2%) plus ThromboSol, a mixture of second-messenger effectors that protect platelets from cold damage. PC pools were treated either with 6% Me(2)SO or with ThromboSol and 2% Me(2)SO and then placed directly in a -80 degrees C freezer or in the vapor phase of a liquid nitrogen freezer (-120 degrees C). After storage for 1 week or for 3 months, samples were removed, thawed, and analyzed. Measurements included cell recovery, biochemical parameters, membrane glycoproteins (GPs), platelet aggregation, and binding of radiolabeled von Willebrand factor (vWF) and fibrinogen. PCs cryopreserved with ThromboSol and 2% Me(2)SO displayed a platelet recovery (90%) equivalent to those frozen with 6% Me(2)SO. Following either cryopreservation procedure, platelets showed increased surface expression of P-selectin and moderate loss of GP Ibalpha in comparison to fresh platelets. The aggregatory response to ristocetin and the binding of vWF were similar in platelets frozen by either procedure. Finally, both methods promoted comparable impairment of the reactivity of platelets to thrombin, aggregation and binding of fibrinogen and vWF, compared to that of fresh platelets. In summary, cryopreservation of PCs using reduced Me(2)SO concentration and ThromboSol yields platelets with in vitro functional characteristics equivalent to those of cells frozen with the conventional method using 6% Me(2)SO.
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Affiliation(s)
- M L Lozano
- Unit of Hematology, Hemotherapy and Clinical Oncology, School of Medicine, Centro Regional de Hemodonación, Murcia, 30003, Spain
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Currie LM, Lichtiger B, Livesey SA, Tansey W, Yang DJ, Connor J. Enhanced circulatory parameters of human platelets cryopreserved with second-messenger effectors: an in vivo study of 16 volunteer platelet donors. Br J Haematol 1999; 105:826-31. [PMID: 10354154 DOI: 10.1046/j.1365-2141.1999.01411.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Platelet transfusion represents an important component of the therapy for thrombocytopenic patients. Prolonged storage capabilities for platelets would alleviate many problems associated with blood banking. Unfortunately, current cryopreservation methods are complex to implement and result in loss of cell number and functional activity. Previous in vitro studies have shown that the use of ThromboSolTM, a platelet-stabilizing formulation, in the cryopreservation of platelets results in significant retention of cell number and in vitro functional activities in addition to reducing the DMSO requirement to only 2%. We evaluated the in vivo circulatory parameters of platelets cryopreserved with ThromboSol. Single donor platelet units were obtained from healthy volunteers (n = 16); the units were then split and cryopreserved with either ThromboSol and 2% DMSO or 6% DMSO alone. Following storage at -80 degrees C for 7-10 d the samples were thawed, washed and radiolabelled with either 51Cr or 111In. The paired samples were then mixed and reinfused into the autologous volunteer. At various time intervals following transfusion a blood sample was drawn and the quantity of circulating labelled platelets was determined. The percent recovery and survival time was determined by multiple-hit analysis. The ThromboSol-treated platelets, as compared to the 6% DMSO-treated platelets, displayed statistically higher percent recovery (40.2% v 28.8%) and survival time (166.3 h v 152.1 h). These results demonstrated that platelets cryopreserved with ThromboSol displayed superior in vitro and in vivo characteristics as compared to the standard 6% DMSO method. The use of ThromboSol allowed for a 3-fold reduction in the DMSO concentration in conjunction with a 40% increase in circulating cell number and normal survival times.
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Affiliation(s)
- L M Currie
- LifeCell Corporation, The Woodlands, Texas, USA
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Vadhan-Raj S, Currie LM, Bueso-Ramos C, Livesey SA, Connor J. Enhanced retention of in vitro functional activity of platelets from recombinant human thrombopoietin-treated patients following long-term cryopreservation with a platelet-preserving solution (ThromboSol) and 2% DMSO. Br J Haematol 1999; 104:403-11. [PMID: 10050726 DOI: 10.1046/j.1365-2141.1999.01178.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Chemotherapy-induced thrombocytopenia represents a significant clinical problem in the management of patients with malignancy. Recombinant human thrombopoietin (rhTPO) is a potent stimulator of platelet production in vivo. The ability to cryopreserve rhTPO-derived platelets would enable the use of autologous platelets during the period of thrombocytopenia. ThromboSol is a platelet-stabilizing formulation consisting of second messenger effectors that inhibit specific activation pathways endogenous to platelets. To investigate the effect of ThromboSol cryopreservation, platelets from rhTPO-treated patients (n = 23) and normal donors were treated with ThromboSol and 2% DMSO and cryopreserved for up to 6 months. The platelets were thawed at different intervals and tested for retention of platelet functional activity in vitro. Following a short-term storage (1 week), the cryopreserved platelets from patients treated with rhTPO exhibited significantly higher retention of functional activities including discoid morphology (70% v 57%), extent of shape change (19% v 13%) stirring shape change (15% v 11%) and hypotonic shock response (56% v 25%), as compared to the cryopreserved platelets from controls. Furthermore, there was no further significant loss of functional activity following cryopreservation for up to 6 months. These findings suggest that cryopreservation of platelets from rhTPO-treated donors may provide a useful novel strategy for autologous or allogeneic donation for subsequent transfusions to manage treatment-related thrombocytopenia.
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Affiliation(s)
- S Vadhan-Raj
- Department of Bioimmunotherapy, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA
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Abstract
Although platelets stored by cryopreservation are effective in hemostasis, they acquire a number of functional defects during storage and preparation for transfusion. In addition to known acquired defects such as defective aggregation, decreased resistance to hypotonic shock, and disc-spherocyte transformation, we have shown that cryopreserved platelets have decreased capacity to adhere to subendothelium, compared to liquid-stored platelets. To investigate this decrease in adhesive capacity of cryopreserved platelets, we measured the major adhesive membrane glycoprotein, GPIb, and the principal aggregatory protein, GPIIb/IIIa, using flow cytometry in fresh platelets or in platelets cryopreserved in 5% DMSO. We also analyzed aggregation of cryopreserved platelets or liquid-stored platelets in response to ristocetin as another measurement of GPIb functional capacity. We found that approximately 15% of cryopreserved platelets lost surface-bound GPIb, while there was no measurable loss of GPIIB/IIIa during cryopreservation. The cryopreserved platelets also showed a significant decrease in aggregation to ristocetin, but no loss of response to the stronger agonist, thrombin. The loss of surface GPIb from cryopreserved platelets was modest in degree, approximately that reported for liquid-stored platelets, and does not seem great enough to account for the observed functional changes in aggregation and adhesion.
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Affiliation(s)
- M Owens
- Eastern Virginia Medical School, Department of Medicine, Norfolk
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Valeri CR. Cryopreservation of human platelets and bone marrow and peripheral blood totipotential mononuclear stem cells. Ann N Y Acad Sci 1985; 459:353-66. [PMID: 3868330 DOI: 10.1111/j.1749-6632.1985.tb20845.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Human platelets in sufficient numbers for a therapeutic transfusion can be collected for preservation either by pooling ABO- and Rh-compatible platelets or by apheresis procedures using mechanical cell-separating machines. Human platelets have been frozen successfully with 5 or 6% dimethyl sulfoxide (DMSO) and stored at -150 or -180 degrees C, respectively. Platelets frozen with 5% DMSO have been stored at -150 degrees C for at least 3 years, and platelets frozen with 6% DMSO have been stored at -80 degrees C for at least 2 years. Approximately 95% of the DMSO usually is removed by washing the platelets after thawing, and the residual DMSO produces no untoward effects. Washed platelets resuspended in plasma can be stored at room temperature for 6 to 8 hr before transfusion. Platelets thus frozen have freeze-thaw-wash recovery values of about 80%. In vivo survival values are only about 50% those seen with fresh platelets, and it is necessary to transfuse twice as many to achieve comparable results. Studies have shown that these platelets have satisfactory circulation, reduce clinical bleeding, and shorten the prolonged bleeding times associated with thrombocytopenia. Studies are now being made on human bone marrow and peripheral blood, from which totipotential cells devoid of immunocompetent cells can be isolated and frozen.
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Melaragno AJ, Carciero R, Feingold H, Talarico L, Weintraub L, Valeri CR. Cryopreservation of human platelets using 6% dimethyl sulfoxide and storage at -80 degrees C. Effects of 2 years of frozen storage at -80 degrees C and transportation in dry ice. Vox Sang 1985; 49:245-58. [PMID: 4060692 DOI: 10.1111/j.1423-0410.1985.tb01119.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Platelet studies were done in healthy male volunteers and in thrombocytopenic patients. Some of the platelets used in the study were isolated by mechanical apheresis using either the Haemonetics blood processor 30, the IBM blood processor 2997 or the Fenwal CS-3000 blood processor before freezing. Other platelets were isolated from individual units of whole blood and pooled before freezing. The platelets were frozen with a 6% cryoprotectant (DMSO) in a polyvinylchloride (PVC) plastic bag or a polyolefin plastic bag at -80 degrees C in a mechanical freezer and stored for as long as 3 years. Some of the frozen platelets were transported in dry ice in polystyrene foam containers to determine whether they would be adversely affected by such treatment. Platelet recovery after freezing, thawing and washing was about 75%. In the healthy male volunteers, in vivo recovery of autologous platelets 1-2 h after transfusion was about 33%, and the life span was about 8 days. In the thrombocytopenic patients, in vivo recovery values were 50% of those from fresh platelets. The transfusion of previously frozen washed platelets reduced clinical bleeding in the thrombocytopenic patients with bleeding. There was no evidence of quality deterioration in platelets after storage at -80 degrees C for at least 2 years, as determined from in vivo recovery and in vivo survival values, nor was there any adverse effect as a result of shipment of the frozen platelets in dry ice in polystyrene foam containers from one facility to another.
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van Imhoff GW, Arnaud F, Postmus PE, Mulder NH, Das PC, Smit Sibinga CT. Autologous cryopreserved platelets and prophylaxis of bleeding in autologous bone marrow transplantation. BLUT 1983; 47:203-9. [PMID: 6311311 DOI: 10.1007/bf00320839] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Autologous platelets were harvested and cryopreserved in eight consecutive patients elected for ablative chemotherapy and autologous bone marrow transplantation (ABMT) for solid malignancy. There was a 19% loss in platelet count after the freeze thaw and wash procedure; with an in vitro functional loss of 40-60%. No correlation could be found for individual platelet transfusions between in vitro functional tests and in vivo recovery. Six consecutive patients received a total of 16 autologous platelet transfusions in the aplastic phase of ABMT. No bleeding was observed during the study period and there was no CMV infection in the recipients. While improvement in freezing and subsequent handling is desirable, autologous cryopreserved platelets can safely be used for the prophylaxis of bleeding during aplasia in patients treated with ABMT.
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Taylor MA. Release of beta-thromboglobulin during the preparation, in vitro storage and cryopreservation of platelet concentrates. J Clin Pathol 1983; 36:811-5. [PMID: 6190844 PMCID: PMC498394 DOI: 10.1136/jcp.36.7.811] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Beta-thromboglobulin is a platelet specific protein which is released from platelets during the platelet release reaction. The amount of beta-thromboglobulin released during various conditions of in vitro storage, including cryopreservation, was compared. The results suggest the measurement of beta-thromboglobulin is unlikely to be of use as a quality control assay for monitoring the in vitro viability of stored platelets.
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Dujovny M, Rozario R, Kossovsky N, Diaz FG, Segal R. Antiplatelet effect of dimethyl sulfoxide, barbiturates, and methyl prednisolone. Ann N Y Acad Sci 1983; 411:234-44. [PMID: 6576697 DOI: 10.1111/j.1749-6632.1983.tb47304.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Melaragno AJ, Abdu WA, Katchis RJ, Vecchione JJ, Valeri CR. Cryopreservation of platelets isolated with the IBM 2997 blood cell separator: a rapid and simplified approach. Vox Sang 1982; 43:321-6. [PMID: 6294995 DOI: 10.1111/j.1423-0410.1982.tb00030.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The equivalent of 5-7 units of platelets, isolated from a single donor with the IBM Blood Cell Processor 2997 using a dual stage separation chamber, was frozen with the cryoprotectant dimethylsulfoxide (DMSO). The DMSO-saline solution was added directly to the platelets, and the platelets were frozen in a polyvinyl chloride plastic bag by storage in a -80 degrees C mechanical freezer. Washing the thawed platelets with a phosphate-buffered sodium chloride-dextrose solution, pH of 5.0, removed about 95% of the DMSO. In vitro freeze-thaw-wash recovery was 80%, and in vivo 51Cr platelet recovery was 31%. Platelet dense body granules were well maintained after freezing, thawing, and washing. This is a safe and effective method of platelet cryopreservation which can be performed in less time than other currently used methods.
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Abstract
Platelets were cryopreserved in four different cryoprotectives-two intracellular (dimethylsulphoxide, glycerol) and two extracellular (hydroxyethyl starch, dextran). The platelets were evaluated according to their yields, hypotonic shock response, and serotonin uptake, which are useful parameters for establishing optimum storage conditions. Hydroxyethyl starch and dextran were found to be poor cryoprotectives while 5% dimethylsulphoxide was the most suitable.
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Abstract
The increased availability of platelets for transfusion has been a major factor in the improved prognosis noted in patients with acute nonlymphocytic leukemia. This review summarizes our current understanding of the proper use of platelet transfusion for patients with leukemia and cancer, with a particular emphasis on the management of alloimmunized patients. The need for careful and close collaboration between the blood bank and the referring clinicians is emphasized. Cryopreservation of autologous platelets, which can be of considerable assistance in the management of alloimmunized patients, and a summary of the large number of questions that still require further investigation are presented.
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Abstract
Platelets were removed from 25 patients with leukemia during remission and were frozen for subsequent transfusion. With 5 per cent dimethyl sulfoxide as a cryoprotective agent, we froze 3 to 5 units of pooled platelet concentrate by simply placing the platelets in the vapor phase of a liquid nitrogen freezer. Ninety-one transfusions of platelets stored for 13 to 400 days were administered. The mean freeze-thaw loss was 13 percent, and the corrected one-hour increment in platelet count was 13,700 per microliter, corresponding to a recovery of 53 per cent of the predicted value. In many patients most or all of the transfusion requirements were met with frozen platelets. Our results indicate that frozen platelets can circulate and function hemostatically. Autologous frozen platelets are of particular value in the management of alloimmunized patients and have become an integral part of our transfusion support program.
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Abstract
Platelet transfusions are of unquestionably proven benefit for the correction of thrombocytopenia or functional platelet disorders, and they have allowed for more intensive antineoplastic therapy. With the advent of blood component therapy most modern blood banks now have the capabilities for supplying at least limited quantities of platelets. Refinements in procurement methods will inevitably lead to a greater supply of platelets and the establishment of larger transfusion programs. These programs will need to incorporate facilities for platelet storage, recruitment of suitable donors, selection of special donors for refractory patients, and methods for quality control. As antineoplastic therapy becomes more aggressive, such transfusion programs will become an integral part of the operation of cancer treatment centers.
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