[Prevention of platelet transfusion refractoriness and HLA alloimmunization by leukocyte filtered platelet transfusion: a meta analysis].

Objective To compare and assess the effectiveness of leukocyte-filtered platelet and standard platelet concentrates transfusion in preventing platelet transfusion refractoriness(PTR) and human leukocyte antigen(HLA)-alloimmunization.Methods Randomized controlled trials(RCTs) or quasi-RCTs comparing leukocyte-filtered platelet with standard platelet concentrates transfusion(up to December 31, 2009) were searched and identified from Medline,EMBASE,The Cochrane Library,and CBM.A meta-analysis was conducted with Cochrane Collaboration's RevMan 5.0.Results The search identified 558 citations in total,in which 7 articles in English were finally included in the meta-analysis.The analysis showed that compared with standard platelet concentrates transfusion,leukocyte-filtered platelet transfusion significantly decreased PTR [RR=0.59,95%CI(0.42,0.82),P=0.002] and HLA-alloimmunization [RR=0.49,95%CI(0.33,0.74),P=0.0006].Subgroup analysis showed that HLA-alloimmunization was significantly reduced by leukocyte-filtered platelet transfusion among the patients with acute myelocytic leukemia [RR=0.42,95%CI(0.32,0.56),P0.00001],while no significant difference was detected in patients with acute lymphoblastic leukemia because of the limited sample size [RR=0.50,95%CI(0.10,2.41),P=0.39].Conclusions The current evidence shows that leukocyte-filtered platelet transfusion can prevent PTR and HLA-alloimmunization more effectively than standard platelet transfusion.Well-designed large-scale RCTs are still needed to further confirm this finding.