Vaickus L, Breitmeyer J B, Schlossman R L, Anderson K C
Serono Laboratories, Inc., Norwell, Massachusetts 02061, USA.
Stem Cells. 1995 Nov;13(6):588-96. doi: 10.1002/stem.5530130603.
Platelet transfusions have long had an important role in the treatment of patients with thrombocytopenia due to disease or myelotoxic treatment or in patients with reduced platelet function. However, platelet transfusions are associated with numerous risks, both immunologic (e.g., transfusion reactions, alloimmunization, immunosuppression) and infectious (e.g., viral, bacterial). In addition, several laboratory and clinical factors can influence post-transfusion platelet recovery. Recent technological advances have introduced the potential for using alternatives to platelet transfusions, such as cytokines or platelet substitutes, which may avoid the risks of transfusion. Platelet development from megakaryocytes is a process that is highly regulated by cytokines and animal research suggests that selected cytokines involved in this process may be useful in the treatment of thrombocytopenia. Newer developments, including the utilization of recombinant cytokines with relatively selective stimulation of platelet production (e.g., interleukin 6 [IL-6]) and the recent discovery of a megakaryocyte colony stimulating factor (thrombopoietin), represent major therapeutic opportunities in the treatment of thrombocytopenia. Platelet substitutes, e.g., thromboerythrocytes, also show promise in the management of platelet deficiencies.
长期以来，血小板输注在治疗因疾病或骨髓毒性疗法导致血小板减少的患者或血小板功能降低的患者中发挥着重要作用。然而，血小板输注与众多风险相关，包括免疫方面（如输血反应、同种免疫、免疫抑制）和感染方面（如病毒、细菌）。此外，一些实验室和临床因素会影响输血后血小板的恢复情况。最近的技术进步带来了使用血小板输注替代方法的可能性，如细胞因子或血小板替代品，这可能避免输血风险。巨核细胞产生血小板的过程受到细胞因子的高度调控，动物研究表明，参与这一过程的特定细胞因子可能对治疗血小板减少症有用。新的进展，包括利用对血小板生成具有相对选择性刺激作用的重组细胞因子（如白细胞介素6 [IL-6]）以及最近发现的一种巨核细胞集落刺激因子（血小板生成素），代表了治疗血小板减少症的主要治疗机会。血小板替代品，如血栓红细胞，在治疗血小板缺乏症方面也显示出前景。
