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频繁血小板捐献者T细胞淋巴缺血的危险因素:最好的合作研究
Richard M Kaufman1, Denese C Marks2, Yael Flamand3
1Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Transfusion
|October 11, 2023
概括
血小板捐赠者频繁吸血,可能会患T细胞淋巴缺血症,尤其是在使用Trima Accel系统与白血病减少系统 (LRS) 腔室时. 血冲洗可以减轻捐赠者的这种风险.
科学领域:
- 血液学 血液学 血液学
- 免疫学 免疫学 免疫学
- 输血医学 输血医学
背景情况:
- 血小板捐赠者可能会经历未知临床意义的T细胞淋巴缺血.
- 常用的是像Trima Accel (带有LRS) 和Fenwal Amicus (没有LRS) 这样的血小板转移仪器.
研究的目的:
- 在使用Trima (LRS+) 与Amicus (LRS-) 仪器的频繁血小板捐献者中比较T细胞种群.
- 在血小板捐献者中识别T细胞淋巴缺血的危险因素.
主要方法:
- 国际,多中心,观察性研究.
- 在频繁的血小板捐献者 (Trima n=131,Amicus n=77) 和对照者 (全血捐献者 n=126) 中比较的T细胞计数.
- 多变量分析以评估淋巴衰竭的危险因素.
主要成果:
- 较低的CD4+T细胞计数 (<200细胞/μL) 在9.9%的Trima捐赠者和4.4%的Amicus捐赠者 (p<.0001) 中观察到.
- 淋巴缺血发生在≥200次终身捐赠的捐赠者中;年龄,终身捐赠和仪器类型是独立的风险因素.
- 在Trima捐赠者的血冲洗后预防了淋巴缺血症 (0%对14.3%,p=.01).
结论:
- 在非瑞斯过程中反复去除淋巴细胞有助于频繁捐献者的T细胞淋巴缺血.
- 白血病减少系统 (LRS) 增加了淋巴缺血的风险,但它可以在没有LRS的情况下发生.
- 血洗是一种可行的策略,可以减轻LRS用户的T细胞淋巴缺血症.
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