Parco Sergio, Vascotto Fulvia
Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy.
Onco Targets Ther. 2012;5:1-5. doi: 10.2147/OTT.S27883. Epub 2012 Jan 26.
The immature (or reticulated) platelet fraction (IPF) is rich in nucleic acids, especially RNA, and can be used as a predictive factor for platelet recovery in platelet immunomediated consumption or in postchemotherapy myelosuppression. Our aim was to determine if transfusions with IPF-rich solutions, during autologous peripheral blood stem cell transplantation, reduce the occurrence of bleeding and hemorrhagic complications.
Transfusions were administered to 40 children, affected with hematological pathologies, who underwent autologous peripheral hematopoietic progenitor cell transplantation. There were two groups of 20 patients, one group treated with IPF-poor and the other with IPF-rich solutions. In the two groups, the conditioning regimen was the same for the same pathology (hematological pathologies: 14 acute lymphoblastic leukemia; twelve acute myelocytic leukemia; four non-Hodgkin's lymphoma; two Hodgkin's lymphoma; eight solid tumors). A new automated analyzer was used to quantify the IPF: the XE2100 (Sysmex, Kobe, Japan) blood cell counter with upgraded software.
The 20 patients who received solutions with a high percentage of IPF (3%-9% of total number of infused platelets) required fewer transfusions than the 20 patients who received transfusions with a low percentage of IPF (0%-1% of total number of infused platelets): 83 versus 129 (mean of number of transfusions 4.15 versus 6.45) and a significant difference was found between the two groups by using the Mann-Whitney test (P < 0.001). The prophylactic transfusions decreased from three to two per week. There was only one case of massive hemorrhage.
The use of IPF solutions reduces the number of transfusions and bleedings after peripheral blood stem cell transplantation in pediatric patients.
未成熟（或网织）血小板分数（IPF）富含核酸，尤其是RNA，可作为血小板免疫介导性消耗或化疗后骨髓抑制中血小板恢复的预测因子。我们的目的是确定在自体外周血干细胞移植期间输注富含IPF的溶液是否能减少出血和出血并发症的发生。
对40例患有血液系统疾病并接受自体外周造血祖细胞移植的儿童进行输血治疗。分为两组，每组20例患者，一组接受低IPF溶液治疗，另一组接受高IPF溶液治疗。两组中，针对相同疾病（血液系统疾病：14例急性淋巴细胞白血病；12例急性髓细胞白血病；4例非霍奇金淋巴瘤；2例霍奇金淋巴瘤；8例实体瘤）的预处理方案相同。使用一种新型自动分析仪对IPF进行定量：配备升级软件的XE2100（Sysmex，日本神户）血细胞计数器。
接受高百分比IPF溶液（占输注血小板总数的3%-9%）的20例患者比接受低百分比IPF溶液（占输注血小板总数的0%-1%）的20例患者需要的输血次数更少：分别为83次和129次（平均输血次数为4.15次对6.45次），使用曼-惠特尼检验发现两组之间存在显著差异（P<0.001）。预防性输血从每周3次减少到2次。仅发生1例大出血病例。
使用IPF溶液可减少儿科患者外周血干细胞移植后的输血次数和出血情况。
