Healthcare Organizations Urge Curbs on Universal Leukoreduction

Update July 23, 2001

Eight healthcare organizations have sent a letter to HHS Secretary Thompson today asking him to take no action toward the implementation of universal leukocyte reduction (ULR) until such time as a scientific consensus in support of leukocyte reduction of all blood products exists.  The eight organizations are the College of American Pathologists (CAP), the American Hospital Association (AHA), American Medical Association (AMA), American Society of General Surgeons, American Society of Hematology (ASH), American Society of Plastic Surgeons, American Thoracic Society, and the American Urological Association.  Organizations that declined to sign the letter were the American Association of Blood Banks (AABB), America's Blood Centers (ABC) and the American Society of Clinical Pathologists.  The American Red Cross is on record as supporting ULR.  As stated in the letter to Secretary Thompson, a meeting with HHS has been requested to discuss this issue. 

College, AMA Collaborate on Leukoreduction Letter to HHS

The College is collaborating with the American Medical Association to persuade Health and Human Services Secretary Tommy G. Thompson not to require universal leukoreduction for the nation's blood supply.

This week, the College and the AMA began gathering signatures for a coalition letter to Thompson that will call on him to leave unchanged the government's current leukoreduction policy.

"We fully endorse advances in blood safety," the College and AMA say in the letter. "We also recognize the public health advantage that can result from leukoreduced blood products for select patients. However, experts in this field are divided about whether universal leukoreduction is appropriate."

The letter follows the June approval by the AMA House of Delegates of a leukoreduction policy based upon the College's recently adopted policy. The AMA policy states that "pending further scientific studies, AMA should advocate that both leukoreduced and non-leukoreduced blood products be made available, and that it should be the physician's prerogative to determine whether or not to use leukoreduced blood, relative to each specific patient's needs." CAP Delegates and the Pathology Section Council supported the policy.

In the letter to Thompson, the College and the AMA note that, depending on the process used, leukoreduction can remove up to 10 percent of red blood cell volume and "will therefore exacerbate already existing blood shortages." The College and the AMA also call on HHS to "take the lead" in accelerating the performance and evaluation of studies on the clinical utility of universal leukoreduction and its impact on the nation's blood supply.

The letter also argues that the decision to use leukoreduced products is a medical decision and should be left to physicians' discretion. HHS "has rightfully regarded decisions about the choice of drug therapy and blood components to be administered to a patient the practice of medicine and beyond their realm of control," the groups say. "No deviation from this practice or exception should be made for leukoreduction."

The College and AMA acknowledge the value of new technologies designed to increase blood and blood product safety, but say they "strongly oppose measures that would compel physicians to use only leukoreduced blood components for patient care and ask the agencies under your direction to lend support to that position." 

© 2001, College of American Pathologists