血小板输血治疗. 血小板输血治疗. 输血后一个小时的增量对于预测需要HLA匹配制剂的需求是有价值的
JAMA
|February 1, 1980
概括
输血后一个小时的血小板计数可以预测癌症患者的免疫接种情况. 较高的校正计数增量 (CI) 表明没有抗体,而较低的CI表明细胞毒性抗体,指导HLA匹配的血小板使用.
科学领域:
- 血液学 血液学 血液学
- 免疫学 免疫学 免疫学
- 在瘤学瘤学.
背景情况:
- 血小板缺血性癌症患者通常需要血小板输血.
- 由于非免疫接种或其他临床因素,可能会出现快速的血小板破坏.
- 标准的18至24小时增量有时不足以评估输血疗效.
研究的目的:
- 评估输血后一小时的血小板计数是否可以区分与免疫接种与快速血小板破坏的其他原因.
- 确定一小时校正计数增量 (CI) 在预测需要HLA匹配血小板的有用性.
主要方法:
- 分析了73名血小板缺血性癌症患者的79例血小板输血.
- 计算一小时校正计数增量 (CI = [输血后计数 - 输血前计数] x 身体表面积 [平方米] / 输血血小板 x 10^9).
- 一小时CI与淋巴细胞毒性抗体的存在以及对HLA匹配输血的反应的相关性.
主要成果:
- 一小时CI>= 10x10^3 /微升与缺少淋巴细胞毒性抗体有关.
- 一小时CI<10x10^3/微升通常与高水平的细胞毒性抗体相关.
- 当初一小时CI> 10x10 ^ 3 / 微升时,与HLA匹配的输血没有显示好处,但在其他情况下有所改善.
结论:
- 输血后一小时的血小板计数是一种简单而有价值的测试,用于预测与免疫接种.
- 该测试与HLA抗体存在相关,并有助于识别那些将从HLA匹配血小板中受益的患者.
- 它有助于避免不必要的和经验性的使用HLA匹配的血小板输血.
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