Panzer S, Maier F, Höcker P, Mayr W R, Hinterberger W
Infusionsther Klin Ernahr. 1987 Apr;14 Suppl 2:10-4.
We determined in 35 patients with severe thrombocytopenia (AML n = 10; ALL n = 4; CML = 1; idiopathic myelofibrosis n = 1, aplastic anemia n = 1; undergoing bone-marrow transplantation n = 17) factors influencing the corrected count increment (CCI) after platelet transfusions. Out of 195 transfusions 86 (44%) failed to increased platelet counts (CCI less than 5 X 10(9) platelets/l). A significant percentage of transfusion failures occurred in patients with splenomegaly and/or fever (54% vs. 29%; p less than 0.002). Antibodies directed against donor platelets were found only twice. No correlation between reactivities demonstrable by the lymphocytotoxic test (n = 144) or the radioimmune antiglobulin test (n = 67) and the CCI was obvious. HLA antigen identity was also not predictive. Thus, transfusion failures in patients with low alloimmunization will not be predicted by in vitro antibody screenings. The patients' clinical condition has the most important influence on posttransfusion increment.
我们在35例严重血小板减少症患者（急性髓系白血病10例；急性淋巴细胞白血病4例；慢性粒细胞白血病1例；原发性骨髓纤维化1例；再生障碍性贫血1例；接受骨髓移植17例）中，确定了影响血小板输注后校正计数增加值（CCI）的因素。在195次输血中，86次（44%）未能增加血小板计数（CCI低于5×10⁹个血小板/升）。相当比例的输血失败发生在脾肿大和/或发热患者中（54%对29%；p<0.002）。仅发现两次针对供体血小板的抗体。淋巴细胞毒性试验（n=144）或放射免疫抗球蛋白试验（n=67）所显示的反应性与CCI之间无明显相关性。HLA抗原匹配也无预测性。因此，低同种免疫患者的输血失败无法通过体外抗体筛查预测。患者的临床状况对输血后增加值影响最大。
