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血液学患者的急性肺损伤得到了病原体减少和常规血小板成分的支持
Allison P Wheeler1, Edward L Snyder2, Majed Refaai3
1Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN.
Blood advances
|March 6, 2024
概括
与常规血小板组件 (CPC) 相比,Amotosalen-UVA病原体减少的血小板组件 (PRPC) 在接受抗瘤治疗的患者中显示,需要机械通风的肺功能障碍的发生率较低.
科学领域:
- 血液学 血液学 血液学
- 输血医学 输血医学
- 肺部医学 肺部医学
背景情况:
- 接受抗瘤治疗的患者经常患有血小板缺血症,需要进行血小板输血.
- 血小板输血带有加剧肺损伤的风险.
- 病原体减少技术旨在减轻输血相关的风险.
研究的目的:
- 为了比较amotosalen-UVA病原体减少血小板成分 (PRPCs) 和常规血小板成分 (CPCs) 之间的需要机械通风的肺功能障碍的发生率.
- 评估其他肺部不良事件,包括临床显著的肺部不良事件 (CSPAE) 和治疗出现的急性呼吸困扰综合征 (TEARDS).
主要方法:
- 一个前性的,多中心的,开放标签的,顺序的队列研究.
- 评估了两个队列:一个接受CPC,其次是接受PRPC的队列.
- 结果包括治疗出现的肺功能障碍 (TEAMV-PD) 辅助机械呼吸,CSPAE和通过盲目判断诊断的TEARDS.
主要成果:
- 与CPC (3.1%) 相比,PRPCs (1.7%) 的TEAMV-PD发生率较低.
- 在需要两次或两次以上的血小板输血的患者中,TEAMV-PD发生率与PRPCs (-2.4%的差异) 减少.
- 虽然CSPAE随着输血暴露增加,但在PRPC和CPC队列之间没有发现显著差异. 在PRPC组中,TEARDS的发病率在数值上较低 (1.3%对2.6%).
结论:
- 与CPC相比,PRPCs在减少需要机械通风的严重肺损伤的可能性很高.
- 贝叶斯分析表明,PRPCs在减少TEAMV-PD和TEARDS方面可能更优越.
- 阿莫托萨伦-UVA PRPC 是可能更安全的选择,用于在患有肺部并发症风险的患者进行血小板输血.
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