Buffy coat pooled platelets a cost-effective alternative to single-donor apheresis platelets for hemato-oncology patients in the Indian scenario: A randomized cross-over study.

BACKGROUND: Buffy coat pooled platelets (BCPP) have recently been licensed for clinical use in India and have merits of both the conventional platelet concentrates, i.e., random donor platelets and single-donor apheresis platelets (SDAPs). Repeatedly, finding a ABO-matched donor for hemato-oncology patients is a challenge. AIM: This study aimed to evaluate feasibility, efficacy, safety, and cost-effectiveness of BCPP in nonrefractory, hemato-oncological patients in comparison to SDAP. METHODS: In a randomized cross-over study design, 93 hemato-oncological patients were assigned either BCPP or SDAP as their first transfusion product. On subsequent requisition for the same patient, the other platelet product was issued for transfusion. Corrected count increment (CCI) and percentage platelet recovery (PPR) were calculated 1 h after the transfusion. Intertransfusion interval, posttransfusion platelet increment, and signs of any adverse transfusion reactions were also noted. A cost analysis was also done. RESULTS: Mean posttransfusion platelet increment was observed to be 37043/μL for BCPP and 30839/μL for SDAP. The mean CCI and PPR 1 h after transfusing was 15003 and 36.42% for BCPP and 15554 and 38.04% for SDAP. The median intertransfusion interval was 96 h after BCPP and 72 h after SDAP transfusion. Multivariate analysis shows that the BCPP is noninferior to SDAP for CCI (-549, 95% confidence interval [CI]: -1129--30), PPR (-1.62, 95% CI: -3.02--0.21), superior for platelet increment (6202, 95% CI: 4742-7661), and for intertransfusion interval (35, 95% CI: 10.5-59.5). No transfusion reactions were reported in any of the patients enrolled. BCPP costs 61% less than the SDAP in our setup. CONCLUSION: This study suggests that in nonrefractory, hemato-oncological patients BCPP is noninferior to SDAP in terms of 1-h posttransfusion CCI and PPR. BCPP costs significantly less and can act as a good alternative to SDAP in resource-constrained settings.