A 30-year-old man with Hodgkin lymphoma who has received extended-field radiotherapy requires repeated red cell transfusions. Which special processing should be applied to his blood components and why?

• A Leucodepletion, to prevent febrile non-haemolytic reactions
• B Frozen deglycerolized storage, to preserve rare antigen-negative units
• C Washing, to remove plasma antibodies in IgA-deficient recipients
• D Irradiation, to prevent transfusion-associated graft-versus-host disease ✓

Explanation

Patients with Hodgkin lymphoma, especially after radiotherapy or fludarabine exposure, have impaired cell-mediated immunity and cannot reject viable donor T lymphocytes in transfused blood, risking fatal transfusion-associated GVHD. Irradiation inactivates donor lymphocytes and is the required precaution. Leucodepletion reduces CMV transmission and febrile reactions but does not reliably eliminate all lymphocytes, so it does not prevent TA-GVHD, killing option A. Washing addresses IgA deficiency and frozen storage preserves rare units, neither relevant here.

Reference: Sabiston Textbook of Surgery, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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