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首页> 外文期刊>Transfusion medicine >Impact of Human Leucocyte Antigen epitope matched platelet transfusions in alloimmunised aplastic anaemia patients
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Impact of Human Leucocyte Antigen epitope matched platelet transfusions in alloimmunised aplastic anaemia patients

机译：人白细胞抗原表位匹配血小板输血在同种免疫障碍性贫血患者中的影响

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Summary Aims/Objectives To explore the impact of Human Leucocyte Antigen (HLA)‐A and B epitope‐matched platelets on the outcome of platelet transfusions in alloimmunised patients with aplastic anaemia (AA). The relevance of HLA‐C epitope mismatches was also investigated. Background Patients who become immunologically refractory (IR) to random platelet transfusions can experience an adequate rise in platelet count through the provision of HLA‐compatible platelets using an antigen‐matching algorithm. This approach has been shown to be effective in patients with a low calculated reaction frequency, but it is not always successful in highly sensitised patients. The use of HLA epitopes‐selected platelets has been suggested as an alternative to the antigen matching approach. Methods The effect of HLA epitope matching (both Eplets and Triplets) on the outcome of platelet transfusion was analysed in 37 highly immunised AA patients previously transfused with HLA‐A and B antigen‐matched platelets. Epitope matching was determined using the HLAMatchmaker programme. The outcome of the transfusions was assessed by the platelet count increments (PCIs) obtained 1 and 24 hours post‐transfusions. Results HLA‐A and B epitope matching was equivalent to HLA antigen matching in raising platelet counts. There was no significant difference in PCI when HLA‐C epitope mismatches were considered. In addition, transfusions with fewer than two antigen mismatches resulted in significantly higher PCIs compared to transfusions with more than two antigen mismatches. Conclusions HLA epitope‐matched platelet provision may represent a clinically effective transfusion strategy for patients IR to random platelet transfusions. Further prospective studies are required.
机译：概述旨在探讨人白细胞抗原（HLA）-A和B表位匹配血小板对血小免疫贫血（AA）血小板输血结果的影响。还研究了HLA-C表位不匹配的相关性。背景患者通过使用抗原匹配算法提供HLA兼容的血小板可以经历血小板输血的免疫碎片输血的患者可以经历足够的血小板计数。这种方法已被证明在计算的反应频率低的患者中有效，但在高度敏感的患者中并不总是成功。已经提出了使用HLA表位的血小板作为抗原匹配方法的替代方案。方法采用HLA-A和B抗原匹配血小板的37例高度免疫的AA患者分析HLA表位匹配（eplets和三联）对血小板输注结果的影响。使用HamamatchMaker程序确定表位匹配。通过输出后1和24小时获得的血小板计数增量（PCI）评估输血的结果。结果HLA-A和B表位匹配相当于血小板计数中的HLA抗原匹配。考虑HLA-C表位错配时，PCI没有显着差异。此外，与具有超过两种抗原不匹配的输血相比，具有少于两种抗原不匹配的输血导致显着更高的PCIS。结论HLA表位匹配血小板拨款可以代表患者IR对随机血小板输血的临床有效的输血策略。需要进一步的预期研究。

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