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用于骨髓捐赠的自体血采集:其效用如何?

Collection of autologous blood for bone marrow donation: how useful is it?

作者信息

Parkkali T, Juvonen E, Volin L, Partanen J, Ruutu T

机构信息

Department of Medicine, Helsinki University Central Hospital, PO Box 340, Helsinki FIN-00029 HUS, Finland.

出版信息

Bone Marrow Transplant. 2005 Jun;35(11):1035-9. doi: 10.1038/sj.bmt.1704967.

Abstract

The hospital charts of 495 adult bone marrow (BM) donors to adult patients were reviewed to determine how necessary it is to collect autologous blood for marrow donation. An autologous transfusion was given to 79% of the donors. The median total volume of marrow harvested was 900 ml (range 450-1350 ml). The median number of nucleated cells harvested was 3.2 x 10(8)/kg patient weight (range 0.9-7.4 x 10(8)/kg patient weight). On the morning following the harvest, the median haemoglobin (Hb) concentrations were 104 g/l (79-135 g/l) in the female and 122 g/l (89-151 g/l) in the male donors autotransfused, and 96 g/l (75-127 g/l) in the female and 119 g/l (88-141 g/l) in the male donors not autotransfused. The post-donation Hb was lower than 85 g/l in four and lower than 90 g/l in 25 donors. Of the 25 donors with post-harvest Hb lower than 90 g/l, 23 were females and 14 had received an autologous transfusion. This study shows that, with a few exceptions, it is not necessary to collect autologous blood from healthy BM donors before the marrow harvest. The post-donation Hb concentrations do not decrease to levels detrimental to healthy persons whether autologous blood is transfused or not.

摘要

回顾了495名成年骨髓捐赠者向成年患者捐赠骨髓的医院病历,以确定为骨髓捐赠采集自体血的必要性。79%的捐赠者接受了自体输血。采集的骨髓中位总体积为900毫升(范围450 - 1350毫升)。采集的有核细胞中位数量为3.2×10⁸/千克患者体重(范围0.9 - 7.4×10⁸/千克患者体重)。采集后的早晨,接受自体输血的女性捐赠者中位血红蛋白(Hb)浓度为104克/升(79 - 135克/升),男性为122克/升(89 - 151克/升);未接受自体输血的女性捐赠者中位Hb浓度为96克/升(75 - 127克/升),男性为119克/升(88 - 141克/升)。4名捐赠者捐赠后的Hb低于85克/升,25名捐赠者低于90克/升。在采集后Hb低于90克/升的25名捐赠者中,23名是女性,14名接受了自体输血。这项研究表明,除少数例外情况外,在采集骨髓前无需从健康的骨髓捐赠者采集自体血。无论是否输注自体血,捐赠后的Hb浓度都不会降至对健康人有害的水平。

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