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血小板同种免疫患者中红细胞和血小板同种抗体的关联

[Association of red blood cell and platelet allo-antibodies in platelet alloimmunized patients].

作者信息

Moncharmont P, Rigal D

机构信息

Laboratoire d'immunologie plaquettaire, Établissement français du sang Rhône-Alpes, site de Lyon Gerland, 1-3, rue du Vercors, 69364 Lyon cedex 07, France.

Laboratoire d'immunologie plaquettaire, Établissement français du sang Rhône-Alpes, site de Lyon Gerland, 1-3, rue du Vercors, 69364 Lyon cedex 07, France.

出版信息

Transfus Clin Biol. 2014 Jun;21(3):99-102. doi: 10.1016/j.tracli.2014.05.004. Epub 2014 Jun 16.

Abstract

PURPOSE OF THE STUDY

Use of matched red blood cell (RBC) concentrates is imperative in patients with RBC allo-antibodies (Abs) and when platelet (PLT) specific allo-Abs are present additional difficulties occur for PLT transfusions. In order to evaluate the prevalence of the PLT and RBC allo-Abs association, a study on patients with PLT specific allo-Acs was performed. This association is not a rare event.

PATIENTS AND METHODS

In the database of a PLT immunohaematology laboratory, patients with PLT specific allo-Abs were selected and the presence and specificity of RBC allo-Abs was evaluated.

RESULTS

Six hundred and eighty seven patients (673 females, 14 males) with PLT specific allo-Abs were found. Six hundred and seventy-five patients (98.3%) had PLT specific allo-Abs with only one specificity. Anti-HPA-5b was the most frequent (539 cases). Twenty-nine (4.2%) patients had also RBC allo-Abs, including 27 females (93.1%) and two males. Seventy (58.6%) had RBC allo-Abs with only one specificity, 10 several and two unknown. Among the first, RBC allo-Abs directed against Rhesus blood group antigens were predominant (11 cases [64.7%]). Among the 29 patients with associated PLT and RBC allo-Abs, 15 (51.7%) were 50 or more years old and 14 (48.3%) under 50.

CONCLUSION

In PLT specific alloimmunized patients, detection of RBC alloimmunization is not a rare event. When RBC and PLT transfusions are required, the supply of matched RBC and PLT concentrates is more difficult.

摘要

研究目的

对于红细胞(RBC)同种抗体(Abs)患者,使用匹配的红细胞浓缩物至关重要,并且当存在血小板(PLT)特异性同种抗体时,血小板输注会出现更多困难。为了评估血小板和红细胞同种抗体关联的发生率,对血小板特异性同种抗体患者进行了一项研究。这种关联并非罕见事件。

患者与方法

在血小板免疫血液学实验室的数据库中,选择血小板特异性同种抗体患者,并评估红细胞同种抗体的存在和特异性。

结果

发现687例(673例女性,14例男性)血小板特异性同种抗体患者。675例(98.3%)患者的血小板特异性同种抗体只有一种特异性。抗HPA-5b最为常见(539例)。29例(4.2%)患者也有红细胞同种抗体,包括27例女性(93.1%)和2例男性。70例(58.6%)患者的红细胞同种抗体只有一种特异性,10例有几种,2例未知。其中,针对恒河猴血型抗原的红细胞同种抗体占主导(11例[64.7%])。在29例血小板和红细胞同种抗体相关患者中,15例(51.7%)年龄在50岁及以上,14例(48.3%)年龄在50岁以下。

结论

在血小板特异性同种免疫患者中,检测到红细胞同种免疫并非罕见事件。当需要输注红细胞和血小板时,提供匹配的红细胞和血小板浓缩物更加困难。

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