Guerrero-Rivera Susana, Gutiérrez-Espíndola Guillermo, Talavera Juan O, Meillón-García Luis Antonio, Pedraza-Echevarría Martha, Pizzuto-Chávez Javier
Departamento de Hematología, Hospital de Especialidades Bernardo Sepúlveda, Centro Médico Nacional Siglo XXI, Mexico City, Mexico.
Arch Med Res. 2003 Mar-Apr;34(2):120-3. doi: 10.1016/S0188-4409(02)00453-8.
Platelet transfusion in thrombocytopenic patients, especially those with marrow failure, remains one of the most important support measures available. Treatment success depends on rational use of platelet transfusion. Platelet yield, reflected in transfused platelet dose, influences platelet recovery in the patient and allows prolonging intervals between transfusions. In this study, our main objective was to identify donor laboratory and clinical factors that showed some influence on platelet yield obtained by apheresis.
Healthy donor laboratory and clinical data were analyzed prior to performing plateletpheresis. Platelet yield was quantified after plateletpheresis procedure was concluded in two different ways: a) prefixed volume of 5,000 mL processed, and b) volume determined according to manufacturer recommendations. Age, gender, hemoglobin concentration, platelet and leukocyte count, height, and weight were included as yield-predicting donor variables.
In group A, two variables were significant: donor platelet count and hemoglobin (Hb) concentrations with r = 0.554, and in group B, donor platelet count, Hb concentrations, and volume with r = 0.758.
Donor platelet count and hemoglobin concentrations influence platelet yield: higher platelet count corresponds to higher yield, while hemoglobin shows an inverse relationship, i.e., the lower the hemoglobin concentrations, the higher the platelet yield.
血小板减少症患者,尤其是骨髓衰竭患者的血小板输注,仍然是现有的最重要的支持措施之一。治疗成功取决于血小板输注的合理使用。以输注的血小板剂量体现的血小板产量,会影响患者体内血小板的恢复情况,并能延长输血间隔时间。在本研究中,我们的主要目标是确定对单采血小板产量有一定影响的供体实验室和临床因素。
在进行血小板单采之前,对健康供体的实验室和临床数据进行分析。血小板单采程序结束后,通过两种不同方式对血小板产量进行量化:a)处理5000 mL的固定体积;b)根据制造商建议确定的体积。纳入年龄、性别、血红蛋白浓度、血小板和白细胞计数、身高和体重作为预测产量的供体变量。
在A组中,两个变量具有显著性:供体血小板计数和血红蛋白(Hb)浓度,r = 0.554;在B组中,供体血小板计数、Hb浓度和体积,r = 0.758。
供体血小板计数和血红蛋白浓度会影响血小板产量:血小板计数越高,产量越高,而血红蛋白呈负相关,即血红蛋白浓度越低,血小板产量越高。