Richa Elie, Krueger Paul, Burgstaler Edwin A, Bryant Sandra C, Winters Jeffrey L
The Department of Laboratory Medicine and Pathology, Division of Transfusion Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
Transfusion. 2008 Jul;48(7):1325-32. doi: 10.1111/j.1537-2995.2008.01669.x. Epub 2008 Mar 13.
Concerned about the effect of multiple platelet (PLT) product donation on donor health, in 2005 the FDA proposed restrictions limiting the number of PLT products donated in 12 months. This was based on limited published evidence. To provide information on the effect of PLT donation on PLT and lymphocyte (LYM) count, hematologic variables were examined in a group of multiple PLT product donors.
Donors with at least two apheresis PLT donations, one of which was a double- or triple-PLT product, were examined. Donor demographics, number of blood donations, and number of apheresis PLT products donated were determined. Hematologic variables were evaluated at the first and last donation.
A total of 471 donors (median age, 48.8 years; 55% male; median time between first and last donations, 72 weeks) were studied. The median number of PLT donations was 4 (range, 1-34) with the median number of PLT products donated being 7 (range, 2-65). The median PLT count demonstrated a significant increase (14 x 10(9)/L, p = 0.0001) while both white blood cell and LYM counts showed significant decreases (-0.2 x 10(9)/L, p = 0.0052; and -0.06 x 10(9)/L, p = 0.0001, respectively). After adjusting for sex and whole-blood donations, LYM count demonstrated a significant decline associated with both number of donations (-0.01 x 10(9)/L, p = 0.01) and number of products donated (-0.005 x 10(9)/L, p = 0.02). PLT count demonstrated a significant increase associated with number of products donated (0.42 x 10(9)/L, p = 0.03).
Significant but small LYM decrease and PLT increase were seen. Limitations on the number of apheresis PLT products donated within 12 months do not seem warranted due to PLT or LYM count changes.
由于担心多次捐献血小板(PLT)产品对捐献者健康的影响,2005年美国食品药品监督管理局(FDA)提议限制12个月内捐献的PLT产品数量。这是基于有限的已发表证据。为了提供有关PLT捐献对PLT和淋巴细胞(LYM)计数影响的信息,对一组多次捐献PLT产品的捐献者的血液学变量进行了检查。
对至少有两次单采血小板捐献(其中一次为双倍或三倍PLT产品)的捐献者进行检查。确定捐献者的人口统计学特征、献血次数和捐献的单采血小板产品数量。在第一次和最后一次捐献时评估血液学变量。
共研究了471名捐献者(中位年龄48.8岁;55%为男性;第一次和最后一次捐献之间的中位时间为72周)。PLT捐献的中位数为4次(范围1 - 34次),捐献的PLT产品中位数为7个(范围2 - 65个)。PLT计数中位数显著增加(14×10⁹/L,p = 0.0001),而白细胞和LYM计数均显著下降(分别为 - 0.2×10⁹/L,p = 0.0052;和 - 0.06×10⁹/L,p = 0.0001)。在对性别和全血捐献进行校正后,LYM计数显示与捐献次数( - 0.01×10⁹/L,p = 0.01)和捐献的产品数量( - 0.005×10⁹/L,p = 0.02)均显著下降有关。PLT计数显示与捐献的产品数量显著增加有关(0.42×10⁹/L,p = 0.03)。
观察到LYM有显著但微小的下降和PLT有增加。由于PLT或LYM计数的变化,似乎没有必要对12个月内捐献的单采血小板产品数量进行限制。