Prevention of transfusion-associated graft-versus-host disease with pathogen-reduced platelets with amotosalen and ultraviolet A light: a review

Abstract

Background and Objectives: Transfusion-associated graft-versus-host disease (TA-GVHD) is a serious complication of blood component transfusion therapy, caused by donor T lymphocytes. γ-Irradiation or pathogen inactivation methods, capable of inactivating proliferating T cells in blood components, should be selected to prevent TA-GVHD. This review summarizes the published evidence to support the use of pathogen-reduced platelets with amotosalen (150 μm) and ultraviolet A light (UVA, 320–400 nm, 3 J/cm2) for preventing TA-GVHD. Materials and Methods: Available literature on the use of pathogen-reduced platelets to prevent TA-GVHD was reviewed. Results: Observational studies, animal models, in vitro studies and mechanistic studies of pathogen-reduced platelets with amotosalen and UVA light showed that inactivation of T cells are equal or even superior to γ-irradiation. Conclusion: Pathogen-reduced platelets with amotosalen and UVA light can be used as a measure to prevent TA-GVHD.