John Libbey Eurotext

Hématologie

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Viral decontamination of labile blood products Volume 7, issue 1, Janvier - Février 2001

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Etablissement français du sang/établissement de transfusion sanguine des Pays de la Loire, 34, boulevard Jean-Monnet, BP 91115, 44011 Nantes cedex 1.

Despite the advances made in the medical selection of blood donors and the effectiveness of screening tests for transfusion-transmitted viruses, the safety of labile blood products could be greatly improved by introducing viral reduction techniques. This article is an update of the available knowledge and data on this subject. Leukocyte depletion of cellular labile blood products, red cell concentrates (RBC) and platelet concentrates (PC), is known to be effective on CMV and HTLV transmission but not on that of hepatits B and C viruses or HIV. Photochemical methods of RBC viral inactivation have not still reached the stage of clinical studies. Biochemical techniques, using alkylating agents, are expected to be applied to RBC transfusion in man in the next three to five years. In contrast, the photochemical techniques applied to PC, using psoralens and UVA illumination, have proven effective in vitro and compatible with acceptable tolerance and effectiveness of PC infusions in phase I and II clinical trials. A European multicentre phase III trial comparing effectiveness and tolerance of photo-inactivated and untreated PC was recently completed in 103 patients. Depending on results (not yet published), viro-inactivated platelet concentrates could be introduced in human medicine within one to two years.