Change In Leukocyte Profile Following A Leukoreduced Red Blood Cell Transfusion In Very Low Birth Weight Preterm Neonates

This submission has open access
Submission ID :
ESPR363
Submission Type
Submission Topic
Abstract: :

Background: Packed red blood cells (PRBC) are the most common blood product administered to sick neonates. Limited studies in pediatric and adult patients have observed leukocytosis after a PRBC transfusion. There are no large studies investigating whether transfusion of critically ill preterm neonates with leucodepleted red cells causes leucocytosis. Recognition of post-PRBC transfusion leukocytosis may avoid unnecessary investigations and therapies in false suspicion of sepsis.

Objective: 
To assess changes in leukocyte and platelet profiles that occur after a transfusion of leukoreduced PRBC in very low birth weight (VLBW ≤1500 gram) preterm neonates (gestational age, GA ≤ 37 weeks).

Design/Methods: 
A retrospective cohort single-center study of VLBW preterm infants who received PRBC transfusion at Brookdale Hospital from January 2014 to June 2019. White blood cell (WBC) and platelet count results within 24 hours pre-transfusion and up to 72 hours post-transfusion were collected. Preterm neonates who do not have complete blood counts (CBC) within 72 hours of PRBC transfusion were excluded. A subset analysis was done for the first transfusion vs. any transfusion. A comparison of laboratory data before and after transfusion was tested for significance using the Wilcoxon signed ranks test or paired T-test as appropriate.

Results: 
A total of 108 VLBW preterm infants with 402 PRBC transfusions were included. Subjects' mean GA was 27.2 ± 2.5 weeks and mean birth weight was 913 ± 264 grams (Table 1). There was no difference in total WBC, absolute neutrophil count (ANC), absolute monocyte count (AMC), absolute eosinophil count, and absolute lymphocyte count between pre and post-transfusion (Table 2). However, the platelet count was decreased in the post-transfusion group ( p <0.001). In the subset analysis for first time transfusion among the 108 infants, total WBC, AMC, ANC were increased significantly post-transfusion (Table 3, Figure 1).

Conclusion(s): 
Our study showed that PRBC transfusions can cause an elevation in neutrophils, monocytes, and eosinophils and a drop in platelets, within 72 hours after transfusion. These changes were only observed after the first transfusion, but not after further transfusions, except for a drop in platelet count. Awareness of these changes may avoid unnecessary evaluation of suspected sepsis, only after the first transfusion. Further studies are needed to identify factors related to PRBC transfusion induced changes in leukocyte and platelets profile.

Optional insertion of tables and or figures :
If the file does not load, click here to open/download the file.
If the file does not load, click here to open/download the file.
Children’s Hospital at Montefiore/Albert Einstein College of Medicine
Neonatology, Hackensack UMC at Pascack Valley, Westwood, NJ, United States.
Brookdale Hospital Medical Center, Queens, NY, United States.
Presbyterian Medical group, Albuquerque, NM, United States.
Pediatrics, Brookdale Hospital Medical Center, Queens, NY, United States.

Similar Abstracts by Type

Submission ID
Submission Title
Submission Topic
Submission Type
Corresponding Author
ESPR157
Clinical Research
Original science
Aditya Chhikara
ESPR302
Epidemiology
Original science
Natasha Jouk
ESPR74
Clinical Research
Original science
Alexandra Mazo
38 hits