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《Chinese Journal of Blood Transfusion》 2018-03
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The impact of repeated transfusion of platelets on patients with hematopoietic disease

LI Zhijing;Liaoning University of Traditional Chinese Medicine Hospital;  
Objective To explore the causes of Platelet transfusion refractoriness( PTR) and seek potential approaches to prevent PTR. Methods The clinical data of 612 patients ranging from January 2017 to May 2017 were collected from the hematology department of the hospital,including: Acute leukemia( AL) 38; aplastic anemia( AA) 40; myelodysplastic syndrome( MDS) 42; idiopathic thrombocytopenic purpura( ITP) 58. The evaluation of platelet transfusion was based on the increase index of platelet correction( CCI). The platelet related antibodies in PTR patients were detected by simple sensitized erythrocyte platelet technique( SEPSA). The factors affecting PTR were analyzed. Results The rate of PTR in the transfusion group was 29. 9%( 183/612). Among them,PTR rates of ITP,AA,MDS and AL were 53. 9%( 69/128),27. 9%( 38/136),25. 9%( 29/112) and 19. 9%( 47/236)( P0. 05),respectively. The PTR rates of the patients were 24. 5%( 58/236),30. 3%( 60/198),34. 7%( 32/92) and 38. 4%( 33/86)( P0. 05),respectively. Platelet related antibody detection in the 82 patients with PTR was performed: The antibody detection rate was 39. 1%( 32/82),among which,antihla was 62. 5%( 20/32),anti-hpa was 6. 25%( 2/32),and self-antibody was 31. 25%( 10/32). The remaining 60. 9%( 50/82) PTR was caused by non-immune factors. The PTR rates of patients with and without fever were 35. 1%( 138/393)and 20. 1%( 44/219)( P0. 05). The PRTR rate of splenomegaly and normal people was 47. 2%( 84/178) and 22. 5%( 98/434)( P 0. 05). Conclusion The PTR rate was the highest among the patients with hematopoietic disease. The effects of fever,splenomegaly,infusion frequency and platelet antibody on platelet transfusion in patients with hematological diseases were significantly affected. Platelet antibody screening for platelet antibody screening in patients with multiple platelet transfusion may help to reduce PTR.
【Fund】: 辽宁省自然科学基金(20170540595)
【CateGory Index】: R457.1;R55
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