在状细胞疾病中减轻输血相关的红血细胞与免疫的策略:回顾性分析
Elizabeth P Crowe1, Chinelo P Onyenekwu1, Jordan Ippolito1
1Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University, Baltimore, Maryland, USA.
Transfusion
|October 9, 2025
概括
对于状细胞病 (SCD) 患者来说,反射扩展抗原匹配是一种具有成本效益的策略,显示出可行的同免疫和输血反应率. 这种方法适用于特定的临床环境.
科学领域:
- 血液学 血液学 血液学
- 输血医学 输血医学
- 免疫学 免疫学 免疫学
背景情况:
- 美国血液学会 (ASH) 建议在状细胞疾病 (SCD) 中对C,E和K进行有限的预防性红细胞 (RBC) 抗原匹配.
- 该机构采用反射扩展抗原匹配策略,在免疫发生之前不启动抗原匹配,然后前性地进行扩展匹配.
- 本研究将该机构的策略与其他红细胞抗原匹配协议进行比较.
研究的目的:
- 为了比较反射扩展抗原匹配与其他RBC抗原匹配策略的免疫率和成本.
- 评估SCD患者反射扩展抗原匹配的临床和经济可行性.
主要方法:
- 对SCD患者的输血数据进行了5年后期的回顾.
- 同免疫率计算为每100个输血的红细胞单位的新抗体.
- 估计了与不同抗原匹配策略相关的成本.
主要成果:
- 在805名患者中,有325名患者符合纳入标准,其中15.4%的患者获得了非免疫接种 (每100个红细胞0.29).
- 抗C,E和K是最常见的抗体;14%的受试者产生了额外的抗体.
- 反射扩展抗原匹配的成本为4,619,133美元,远低于预防性有限 ($ 9,578,253) 或扩展 ($ 14,537,373) 匹配的预计成本.
结论:
- 反射式扩展抗原匹配证明了对选定的设置的可行方法,考虑到其相对较低的成本.
- 同免疫和延迟的血液溶解输血反应 (DHTRs) 的比率是可以接受的,尽管排除了一些反应者的局限性.
- 这一策略为SCD患者的RBC抗原匹配提供了具有成本效益的替代方案.
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