Comparing the efficacy and safety of apheresis and whole blood–derived platelet transfusions: a systematic review
Bibliographic record
Abstract
BACKGROUND: A systematic review and meta-analysis was performed to determine if there were differences between apheresis platelet concentrates (APCs) or platelets (PLTs) derived from whole blood (WBD) for the outcomes acute reactions, alloimmunization, refractoriness, corrected count increment (CCI), radiolabeled recovery and survival, time to next transfusion, and bleeding. STUDY DESIGN AND METHODS: We searched Medline, Embase, the Cochrane Registry of Controlled Trials, PapersFirst, ProceedingsFirst, and AABB and ASH abstracts for randomized controlled trials (RCTs) comparing APCs and WBD PLTs for clinical outcomes. Study selection, data extraction, and methodologic quality assessments were performed in duplicate. Results were pooled using meta-analytic methods. RESULTS: Ten RCTs met the inclusion criteria. Acute reactions per patient were lower for APCs (relative risk [RR], 0.65; 95% CI, 0.44-0.98); however, when controlling for leukoreduction, there was no significant difference (leukoreduced [LR]-APCs vs. LR-WBDs; odds ratio, 1.78; 95% CI, 0.87-3.62). There was no difference between products when reaction frequencies were assessed per transfusion (RR, 0.65; 95% CI, 0.33-1.28). APCs were associated with significantly higher CCIs than WBD PLTs at both 1 hour (weighted mean difference [WMD], 2.49; 95% CI, 2.21-2.77) and 18 to 24 hours (WMD, 1.64; 95% CI, 0.60-2.67). No conclusions could be made for the outcomes of alloimmunization and refractoriness. No studies addressed outcomes of time to next transfusion or bleeding. CONCLUSIONS: Owing to the small number of trials and lack of comparability of PLT products for leukoreduction, we were unable to draw definitive conclusions about the clinical benefits of APCs compared with WBD PLTs. Rigorous RCTs using clinically important end points are needed to settle this issue.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.042 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.018 | 0.022 |
| Bibliometrics | 0.007 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".