Tsubaki K
Third Department of Internal Medicine, Kinki University, School of Medicine.
Rinsho Ketsueki. 1993 May;34(5):588-92.
We analyzed the production of anti-platelet antibodies by alloimmunization and examined the prevention of alloimmunization in patients with hematological disorders who have received blood transfusion frequently. HLA antibodies were detected by anti-human globulin lymphocyte cytotoxicity test (AHG-LCT), and anti-platelet antibodies by flow cytometry and mixed passive hemagglutination test (MPHA). A leukocyte removal filter was used for preventing production of alloantibodies. The leukocytes in blood derivatives were removed over 99% by use of this filter. Production of HLA antibodies was detected in 32.7% in control group, but was decreased to 17.1% (p < 0.025) in the filter group. Anti-platelet specific antibodies were detected in 5 patients (5/226; 2.2%) and these antibodies existed together with HLA antibodies in all such patients. The antibodies in the 3 patients out of them were identified as HPA-2b (Siba), and those in the other 2 patients were considered to be combined antibodies by means of platelet identification panel and immunoblotting. Thus, the leukocyte removal filter was found useful for preventing production of HLA antibodies, and measures against HPA-2b are considered necessary because platelet specific antibodies were produced in 2.2% of patients who received blood transfusion frequently.
我们分析了同种免疫产生的抗血小板抗体，并研究了频繁输血的血液系统疾病患者同种免疫的预防措施。通过抗人球蛋白淋巴细胞毒性试验（AHG-LCT）检测HLA抗体，通过流式细胞术和混合被动血凝试验（MPHA）检测抗血小板抗体。使用白细胞去除滤器来预防同种抗体的产生。使用该滤器可去除血液制品中超过99%的白细胞。对照组中HLA抗体的产生率为32.7%，而滤器组降至17.1%（p<0.025）。在5例患者（5/226；2.2%）中检测到抗血小板特异性抗体，所有这些患者的此类抗体均与HLA抗体同时存在。其中3例患者的抗体被鉴定为HPA-2b（Siba），另外2例患者的抗体通过血小板鉴定板和免疫印迹法被认为是混合抗体。因此，发现白细胞去除滤器有助于预防HLA抗体的产生，由于频繁输血的患者中有2.2%产生了血小板特异性抗体，因此认为有必要采取针对HPA-2b的措施。
