Pathogen Inactivation Strategies to Improve Blood Safety

Prophylactic platelet transfusion is a core therapy in patients undergoing chemotherapy, especially for hematologic malignant neoplasms. This issue of JAMA Oncology reports the outcome of a notable randomized clinical trial conducted by a group of French investigators using platelet concentrates prepared by the French blood transfusion service, the Etablissement Français du Sang, which goes by the acronym EFFIPAP. The noninferiority study investigated whether the treatment of platelet concentrates with a first-generation pathogen inactivation technology based on the activation of amotosalen by UV light produces a clinically demonstrable change in platelet transfusion efficacy. Of significance, the study looked at pathogen-inactivated platelets suspended in a particular platelet additive solution (PAS), platelets in the same PAS alone, and platelets suspended in plasma. While pathogen-reduced platelets were noninferior to platelets suspended in PAS, they were inferior with respect to prevention of World Health Organization grade 2 or higher bleeding when compared with platelets in plasma.

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