Siriraj Center of Excellence for Stem Cell Research, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Division of Hematology and Oncology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Thromb Res. 2018 Sep;169:8-14. doi: 10.1016/j.thromres.2018.07.007. Epub 2018 Jul 4.
Bone marrow transplantation (BMT) is the only curable option for thalassemia major, β-thalassemia/HbE. However, some patients still have the risk of hypercoagulable complications. We used a whole blood flow cytometric analysis to measure the circulating microparticle (MP) levels, activated platelets, and leukocyte-platelet aggregates in 59 young β-thalassemia/HbE patients compared with 20- and 28-matched healthy and patients receiving regular blood transfusion (RT), respectively. Results from the studies showed that blood samples from BMT group contained a significantly higher numbers of circulating MPs originated from platelets (ann-VCD41a), leukocyte (ann-VCD45) and endothelial cells (ann-VCD146) when compared to samples from healthy subjects and RT patients. In contrast, the percentages of activated/procoagulant platelets (CD62P and CD142 expressing platelets) were decreased in BMT group. In addition, monocytes forming microaggregates were the major population among other leukocyte-platelet complexes. Different patterns of CD11b, CD62P and CD142 expression on platelet-leukocyte microaggregate surface were also found. These data suggest that circulating MPs together with leukocyte-platelet aggregates may be responsible, in part, in pathogenesis of hypercoagulable state in β-thalassemia/HbE patients who undergone BMT.
骨髓移植(BMT)是重型β地中海贫血/血红蛋白 E 唯一可治愈的选择。然而,一些患者仍有发生高凝并发症的风险。我们使用全血流式细胞术分析,比较了 59 例年轻的β地中海贫血/血红蛋白 E 患者与 20 例和 28 例匹配的健康人和接受常规输血(RT)的患者的循环微粒(MP)水平、活化血小板和白细胞-血小板聚集体。研究结果表明,与健康受试者和 RT 患者的样本相比,BMT 组的血液样本中源自血小板(ann-VCD41a)、白细胞(ann-VCD45)和内皮细胞(ann-VCD146)的循环 MPs 数量明显更高。相比之下,BMT 组中活化/促凝血小板(表达 CD62P 和 CD142 的血小板)的百分比降低。此外,在其他白细胞-血小板复合物中,形成微聚集体的单核细胞是主要群体。还发现血小板-白细胞微聚集体表面 CD11b、CD62P 和 CD142 的表达存在不同模式。这些数据表明,循环 MPs 与白细胞-血小板聚集体一起可能部分导致接受 BMT 的β地中海贫血/血红蛋白 E 患者发生高凝状态的发病机制。