Department of Transfusion Medicine, Tata Memorial Hospital, Homi Bhabha National Institute, Dr E Borges Road, Parel, Mumbai, India.
Department of Transfusion Medicine, Tata Memorial Hospital, Homi Bhabha National Institute, Dr E Borges Road, Parel, Mumbai, India.
Transfus Apher Sci. 2020 Oct;59(5):102842. doi: 10.1016/j.transci.2020.102842. Epub 2020 Jun 9.
To assess platelet crossmatch result by SPRCA and find its correlation with post-transfusion platelet count increment among adult hemato-oncology patients.
A prospective observational pilot study of 50 adult hematologic malignancy patients previously transfused, but not already known to be transfusion-refractory and without any nonimmune causes for inadequate response to platelet transfusion were included after obtaining informed consent. They were transfused one unit of ABO identical single donor platelet. Ten minutes to 1 -h post-transfusion CCI was calculated. CCI ≥ 7500 was considered as adequate response. Post-transfusion crossmatching by SPRCA was performed by using preserved platelet samples from donor units with the serum of the respective patient. Statistical analysis of the correlation between platelet crossmatch results and CCI was done.
Out of 50 crossmatches, 78% (39/50) showed compatible and 22% (11/50) showed incompatible results. Among 39 compatible results, 87.2% (34/39) showed adequate CCI and 12.8% (5/39) showed inadequate CCI. Among 11 incompatible results, 18.2% had adequate CCI and 81.8% had inadequate CCI. The difference between the response in terms of CCI to compatible and incompatible crossmatches was found to be statistically significant (p < 0.05). Other variables like age, sex, number of previous transfusions and underlying clinical condition of the patient were not found to have any effect on the compatibility of crossmatch.
Transfusion of crossmatched platelets to non-refractory, multiply transfused hematological malignancy patients without serious illness might provide a small benefit over transfusing randomly selected platelets, though these data must be confirmed with a larger sample size.
评估固相血小板交叉配型（SPRCA）的结果，并寻找其与成年血液肿瘤患者输血后血小板计数增加的相关性。
这是一项前瞻性观察性试点研究，共纳入 50 名先前接受过输血但已知不是输血难治且无任何非免疫原因导致血小板输注反应不足的成年血液恶性肿瘤患者，在获得知情同意后纳入研究。他们输注了 1 单位 ABO 同型单供者血小板。在输血后 10 分钟至 1 小时内计算 CCI。CCI≥7500 被认为是充分反应。使用供者单位保存的血小板样本和患者相应的血清进行 SPRCA 后输血交叉配型。对血小板交叉配型结果与 CCI 之间的相关性进行了统计学分析。
在 50 次交叉配型中，78%（39/50）显示相容，22%（11/50）显示不相容。在 39 次相容结果中，87.2%（34/39）显示 CCI 充分，12.8%（5/39）显示 CCI 不足。在 11 次不相容结果中，18.2%有充分的 CCI，81.8%有不足的 CCI。相容和不相容交叉配型的 CCI 反应之间的差异具有统计学意义（p<0.05）。年龄、性别、先前输血次数和患者的基础临床状况等其他变量均未发现对交叉配型的相容性有任何影响。
在没有严重疾病的非难治性、多次输血的血液恶性肿瘤患者中输注交叉配型血小板可能比输注随机选择的血小板提供稍小的益处，但这些数据必须用更大的样本量来证实。
