Yamamoto M, Ideguchi H, Nishimura J, Nawata H, Inaba S, Tokunaga K, Kiyokawa H, Maeda Y
Third Department of Internal Medicine, Faculty of Medicine, Kyushu University, Pukuoka, Japan.
Am J Hematol. 1990 Mar;33(3):220-1. doi: 10.1002/ajh.2830330312.
The development of alloantibodies to platelets is a major problem in the supportive management of thrombocytopenia in patients with severe aplastic anemia. We report here a case of aplastic anemia refractory to platelet transfusion. An immunosuppressant, cyclosporin A, which was used for the therapy of aplastic anemia, modulated alloimmunization to platelets in this patient, followed by repeated platelet transfusion. The treatment reduced platelet alloantibodies detected by anti-human immunoglobulin lymphocytotoxicity test, with change of the CD4/CD8 ratio in T lymphocytes in peripheral blood. These results suggest the usefulness of cyclosporin A for the prevention of platelet alloimmunization.
对血小板产生同种抗体是重型再生障碍性贫血患者血小板减少支持治疗中的一个主要问题。我们在此报告一例对血小板输注无效的再生障碍性贫血病例。一种用于治疗再生障碍性贫血的免疫抑制剂环孢素A，调节了该患者对血小板的同种免疫反应，随后进行了反复的血小板输注。该治疗降低了通过抗人免疫球蛋白淋巴细胞毒性试验检测到的血小板同种抗体，并使外周血T淋巴细胞中的CD4/CD8比值发生了变化。这些结果提示环孢素A在预防血小板同种免疫方面的有效性。
