EFFICACY OF LEUCOREDUCTION THERAPY IN CLINICAL PRACTICE: A COMPREHENSIVE REVIEW

Dr. Sharique Ahmad*, Dr. Ahmad Raza, Dr. Nishtha Bassi and Dr. Nishat I. Iram

ABSTRACT

Leucoreduction therapy, aimed at removing leukocytes from blood products before transfusion, has been extensively studied to evaluate its efficacy in clinical practice. This comprehensive review examines the impact of leucoreduction on patient outcomes, transfusion-related complications, and blood product safety. The review highlights the rationale behind leucoreduction and its mechanisms of action in reducing adverse reactions. It discusses the effectiveness of leucoreduction in mitigating febrile reactions, infections, transfusion-associated graft-versus-host disease, and alloimmunization. Furthermore, the review explores the safety aspects, including the impact on blood product quality and cost-effectiveness. Overall, leucoreduction therapy demonstrates effectiveness in reducing transfusion-related complications and improving blood product safety, with considerations for further research and optimization in different clinical settings. Leucoreduction therapy, also known as leukocyte reduction or leukodepletion, is a procedure aimed at removing leukocytes, primarily white blood cells, from blood products before transfusion. This comprehensive review evaluates the efficacy of leucoreduction therapy in clinical practice, focusing on its impact on patient outcomes, transfusion-related complications, and overall blood product safety. The review begins by examining the rationale behind leucoreduction therapy, which includes mitigating adverse reactions associated with transfusions, such as febrile non-haemolytic reactions, alloimmunization, and transfusion-related acute lung injury (TRALI). It explores the mechanisms by which leukocytes contribute to these complications, emphasizing the immunological and inflammatory processes involved. The impact of leucoreduction on clinical outcomes is extensively discussed, incorporating findings from numerous studies across different patient populations and medical settings. The review addresses the effectiveness of leucoreduction in reducing febrile reactions, infection rates, transfusion-associated graft-versus-host disease (TA-GVHD), and alloimmunization. Additionally, it evaluates the role of leucoreduction in preventing TRALI, a severe pulmonary complication associated with transfusions. Furthermore, the review examines the safety of leucoreduced blood products by analysing the potential risks and benefits of the procedure. It explores the impact of leucoreduction on blood product quality, including red blood cell and platelet function, as well as the potential for increased storage lesions and decreased shelf life. The impact on the availability and cost-effectiveness of leucoreduced blood products is also addressed. The comprehensive analysis reveals that leucoreduction therapy is effective in reducing the incidence of transfusion-related complications, particularly febrile reactions, alloimmunization, and TRALI. However, its impact on infection rates remains inconclusive. While there are concerns regarding storage lesions and increased cost, the overall safety and availability of leucoreduced blood products are acceptable for clinical use. In conclusion, this comprehensive review provides valuable insights into the efficacy of leucoreduction therapy in clinical practice. Leucoreduction demonstrates significant benefits in reducing transfusion-related complications, enhancing patient safety, and improving the overall quality of blood products. Nonetheless, further research is warranted to address remaining uncertainties and optimize the implementation of leucoreduction strategies in different clinical settings.

Keywords: Leucoreduction Therapy, Leukodepletion, Transfusion-Related Complications, Alloimmunization, Transfusion-Related Acute Lung Injury (TRALI)