Department of Laboratory Medicine, Yale University School of Medicine & Yale-New Haven Hospital, New Haven, CT, USA.
Department of Laboratory Medicine, Yale University School of Medicine & Yale-New Haven Hospital, New Haven, CT, USA.
Transfus Apher Sci. 2022 Apr;61(2):103402. doi: 10.1016/j.transci.2022.103402. Epub 2022 Mar 11.
Transfusion-associated graft-versus-host disease (TA-GvHD) is a rare but devastating disease with a very high mortality rate. Because of the high mortality and lack of effective treatments, the current state of the art is aimed at preventing TA-GvHD and this can be accomplished via irradiation of all cellular blood products (red blood cells, granulocytes, and platelets). However, given that TA-GvHD is driven by contaminating white blood cells, and the fact that the international transfusion community has largely embraced leukoreduction, this raises the question as to whether the quantitative reduction of leukocytes via filtration can itself prevent TA-GvHD, thus allowing hospitals to skip irradiation steps? In this paper, we review the medical literature to determine how many leukocytes are needed to be removed to prevent TA-GvHD, while providing brief overviews of this entity itself and current irradiation strategies.
输血相关移植物抗宿主病（TA-GvHD）是一种罕见但具有毁灭性的疾病，死亡率非常高。由于死亡率高且缺乏有效治疗方法，目前的重点是预防 TA-GvHD，这可以通过对所有细胞血液制品（红细胞、粒细胞和血小板）进行辐照来实现。然而，鉴于 TA-GvHD 是由污染的白细胞驱动的，并且国际输血界已经在很大程度上接受了白细胞减少，这就提出了一个问题，即通过过滤定量减少白细胞本身是否可以预防 TA-GvHD，从而使医院跳过辐照步骤？在本文中，我们回顾了医学文献，以确定需要去除多少白细胞来预防 TA-GvHD，同时简要概述了该疾病本身和当前的辐照策略。
