Chow M P, Yung C H, Tzeng J L, Hu H Y, Lin W M
Blood Bank, Department of Medicine, Veterans General Hospital-Taipei, R.O.C.
Zhonghua Yi Xue Za Zhi (Taipei). 1991 Apr;47(4):237-41.
Twenty-three patients with leukemia and ten patients with aplastic anemia who needed long-term platelet transfusion were regularly screened for platelet associated antibodies by a combination of platelet suspension immunofluorescence test (PSIFT) and lymphocytotoxicity test (LCT). Subsequently 13 of the patients (56.5%) with leukemia and 7 of the patients with aplastic anemia (70%) became alloimmunized. The overall incidence was 60.6% (20/33). The concordance of PSIFT and LCT was 100%, suggesting that all the platelet associated antibodies were of HLA specificity. The identified antibodies were anti-A2, A11, A24, B5, B40, B46, B57, B60 and B62. Most of them were antibodies against the high frequency HLA antigens in the Chinese population. There was no dose-response relationship in the development of alloimmunization. The interval between the initiation of platelet transfusion and the development of antibody varied from 10 to 192 days. The immunization is of all or none response. In our study group, about 40% of the patients who did not develop alloantibody within six months will never do so. We concluded that platelet transfusion should not be withheld for fear of alloimmunization and that HLA matched or lymphocytotoxic compatible platelet-donors may be helpful to alloimmunized patients.
对23例白血病患者和10例需要长期血小板输注的再生障碍性贫血患者，采用血小板悬液免疫荧光试验（PSIFT）和淋巴细胞毒性试验（LCT）联合检测的方法定期筛查血小板相关抗体。随后，13例白血病患者（56.5%）和7例再生障碍性贫血患者（70%）发生了同种免疫。总发生率为60.6%（20/33）。PSIFT和LCT的一致性为100%，提示所有血小板相关抗体均具有HLA特异性。鉴定出的抗体有抗A2、A11、A24、B5、B40、B46、B57、B60和B62。其中大多数是针对中国人群中高频HLA抗原的抗体。同种免疫的发生不存在剂量反应关系。从开始输注血小板到产生抗体的间隔时间为10至192天。免疫反应为全或无反应。在我们的研究组中，约40%在6个月内未产生同种抗体的患者将永远不会产生。我们得出结论，不应因担心同种免疫而停止血小板输注，并且HLA配型或淋巴细胞毒性相容的血小板供体可能对同种免疫患者有帮助。
