[在2023年,有没有地方可以进行粒细胞输血?]
Adrien Barzin1, Claire Maquet1, Anaïs Devey2
1Service d'Hématologie clinique, CHU Liège, Belgique.
Revue medicale de Liege
|February 15, 2024
概括
尽管采集方法得到了改进,但对中性衰竭感染的颗粒细胞输血的益处证据有限. 需要进一步的研究来证明它们的有效性,并为潜在的未来使用标准化程序.
科学领域:
- 血液学 血液学 血液学
- 传染性疾病 传染性疾病
- 输血医学 输血医学
背景情况:
- 细菌和真菌感染是中性衰竭患者的重大并发症.
- 颗粒细胞输血是在20世纪中叶开发的,在可活细胞采集方面面临着早期的限制.
- 亚菲雷斯和供体预处理 (皮质类固醇,G-CSF) 的进步提高了颗粒细胞收集产量.
研究的目的:
- 评估目前对中性衰竭患者的粒细胞输血的临床有用性.
- 评估改进的采集技术对输血疗效的影响.
- 确定粒细胞输血治疗的挑战和未来方向.
主要方法:
- 历史临床试验和最近研究的审查,包括最大的前性随机对照研究.
- 分析由于非和供体预处理而改善的采集产量,使用颗粒细胞殖民地刺激生长因子 (G-CSF).
- 考虑程序的复杂性,捐赠者的负担,成本和不良影响.
主要成果:
- 最大的随机对照研究发现,治疗性颗粒细胞输血对死亡率或感染控制没有显著的益处.
- 由于G-CSF时代以来的小案例系列和有限的研究,证据质量仍然很低.
- 颗粒细胞输血是复杂的,昂贵的,并带有风险,目前的做法因中心而异.
结论:
- 在中性衰竭患者中,颗粒细胞输血的临床有效性仍然不确定.
- 新出现的多耐药病原体可能会在未来增加粒细胞输血的相关性.
- 程序的标准化和有效性的最终证明是关键的未来挑战.
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