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体外光化学疗法对血液和凝血参数的影响。

Impact of extracorporeal photopheresis on blood and coagulation parameters.

机构信息

Department of Dermatology, Ruhr-University Bochum, Bochum, Germany.

出版信息

Dermatol Ther. 2022 May;35(5):e15366. doi: 10.1111/dth.15366. Epub 2022 Feb 18.

Abstract

Extracorporeal photopheresis (ECP) is considered a safe treatment modality. We aimed to assess blood parameters including coagulation during ECP over time. We performed a long-term retrospective single-center chart review (laboratory parameters) of adult patients (n = 172) who had received ECP for any indication. We observed a significant decrease (p < 0.05) in erythrocytes, hemoglobin, and leukocytes compared to baseline levels after only one ECP procedure. This decrease persisted after 3-, 6-, 9-, and 12-months of ECP. A significant pathological decline of hemoglobin was observed in a higher proportion (26.4% and 25.2%, respectively) of patients after 6 (p = 0.0007) and 12 (p = 0.012) months of ECP. Mean corpuscular volume as well as hematocrit was significantly decreased at 3-, 6-, 9-, and 12-months of evaluation compared to baseline (p < 0.05). After 9 and 12 months of ECP we observed a further decline in lymphocyte counts (p < 0.05). Various coagulation parameters did not change significantly during ECP treatment. Even though not all alterations observed in peripheral blood of ECP patients in the present study were of clinical significance, risk for developing persistent anemia must be considered in patients undergoing ECP.

摘要

体外光化学疗法(ECP)被认为是一种安全的治疗方式。我们旨在评估 ECP 过程中随时间变化的血液参数,包括凝血功能。我们对接受 ECP 治疗的成人患者(n=172)进行了一项长期回顾性单中心图表回顾(实验室参数),这些患者接受 ECP 治疗的原因各不相同。我们观察到,与基线水平相比,仅进行一次 ECP 程序后,红细胞、血红蛋白和白细胞显著下降(p<0.05)。这种下降在 ECP 治疗 3、6、9 和 12 个月后仍然存在。在 ECP 治疗 6(p=0.0007)和 12(p=0.012)个月后,更多的患者出现了血红蛋白病理性下降(分别为 26.4%和 25.2%)。与基线相比,在评估的 3、6、9 和 12 个月时,平均红细胞体积和红细胞压积显著降低(p<0.05)。在 ECP 治疗 9 和 12 个月后,我们观察到淋巴细胞计数进一步下降(p<0.05)。在 ECP 治疗期间,各种凝血参数没有显著变化。尽管本研究中 ECP 患者外周血中观察到的并非所有改变都具有临床意义,但在接受 ECP 治疗的患者中,必须考虑持续贫血的风险。

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