同种免疫性血小板输注无效的治疗性血浆置换。

Therapeutic plasma exchange in alloimmune platelet refractoriness.

机构信息

Division of Hematology, University of Toronto, Canada.

Division of Hematology, University of Toronto, Canada; Division of Malignant Hematology and Oncology, Princess Margaret Cancer Center, Canada.

出版信息

Transfus Apher Sci. 2023 Dec;62(6):103782. doi: 10.1016/j.transci.2023.103782. Epub 2023 Aug 3.

DOI:10.1016/j.transci.2023.103782

PMID:37550092

Abstract

Patients with alloimmune platelet refractoriness can present complex clinical conundrums. Herein we describe a case of platelet refractoriness in the setting of combined HLA and HPA alloimmunization in a patient with acute myeloid leukemia and life-threatening bleeding. We discuss causative antibodies and compare prevailing therapeutic modalities. We highlight plasma exchange as a potentially feasible, repeatable, and personalized treatment option for patients with extensive platelet alloimmunization who require transfusion.

摘要

伴有同种免疫性血小板反应性降低的患者可能会出现复杂的临床难题。本文报告了 1 例急性髓系白血病并伴有危及生命的出血的患者，同时存在 HLA 和 HPA 同种免疫的血小板反应性降低。我们讨论了可能的致病抗体并比较了现有的治疗方法。我们强调了对于需要输注血小板的广泛血小板同种免疫患者，血浆置换作为一种潜在可行、可重复和个体化的治疗选择。