BLOOD CENTERS - THE EFFECT OF CYTOKINE THERAPY ON TRANSFUSION MEDICINE

Platelet concentrates (PCs) are transfused mainly to patients with hae matological disease. World-wide, the use of platelets is still increas ing due, in part, to more intensive treatment schedules for such patie nts. Patients transplanted with cytokine mobilised peripheral blood st em cells (PBSC) have a shortened duration of thrombocytopenia and requ ire fewer platelet transfusions. The principal thrombopoietic cytokine megakaryocyte growth and differentiation factor (MGDF) - has been ide ntified and is now being evaluated in clinical trials. MGDF treatment is likely to be widely used in patients with haematological malignanci es to shorten thrombocytopenia resulting from marrow failure. Platelet transfusions will still be required in patients with malignant diseas e pre-and early post-treatment before MGDF is effective, and in patien ts with thrombocytopenia caused by massive blood loss or following maj or surgery. MGDF will, however, reduce the overall requirement for pla telets. Transfusion of blood components is associated with a number of adverse effects including viral transmission. Novel strategies such a s photodynamic treatment of blood components may maximise the safety o f PCs. Erythropoietin (EPO) is clinically indicated for correction of anaemia in a minority of patients and will not significantly affect th e requirement for red cell transfusions. (C) 1997 Elsevier Science Ltd .