冷冻保存自体血小板输注式造血干细胞移植治疗恶性血液病

来源 :医学研究杂志 | 被引量 : 0次 | 上传用户:haha300n
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目的观察冷冻保存自体血小板输注式造血干细胞移植的临床效果。方法在8例造血干细胞移植过程中进行了22例次冷冻保存自体血小板回输。采用COBE单采机采集血小板,加5%二甲亚砜(DMSO)血小板冻存保护剂,置-80℃冰箱冷冻保存1~3个月。40℃水浴复苏冻存血小板。血小板<20×109/L时回输冻存血小板。测定冻存血小板CD41、CD42b、CD61、CD62P、CD63、回收率及血小板校正增加值(CCI)。结果移植后一般需输注冻存自体血小板2~4次。血小板冻存后回收率在47%~87%之间,平均回收率为(72.73±10.49)%。在22例次血小板冷冻保存回输中,流式细胞仪测定发现有12例次冻融后的血小板CD62P百分比值升高,7例次冻融后的血小板CD63百分比值升高,表明血小板出现了一定程度的活化。有4例次冻融后的血小板CD41或CD42b百分比值减低,表明血小板的黏附聚集功能受到一定程度的影响。输注后CCI在(5.6~17.6)×109/L之间,22次回输中有18次的CCI在7.5之上。移植过程中无出血发生,回输后也未出现并发症。结论造血干细胞移植时采用冻存自体血小板输注可以防止移植过程中出血的发生,代替异体血小板输注而杜绝诸如艾滋病毒、巨细胞病毒等造成的输血传播性疾病的发生,回输是安全和切实可行的。 Objective To observe the clinical effect of cryopreserved autologous platelet transfused hematopoietic stem cell transplantation. Methods Totally 22 autologous platelet transfusions were performed in 8 hematopoietic stem cell transplantation. Platelets were harvested by COBE single machine and protected with 5% dimethyl sulfoxide (DMSO) platelet cryoprotectant. The platelets were stored at -80 ℃ for 1 to 3 months. 40 ℃ water bath resuscitation frozen platelets. Platelets were transfused when platelets <20 × 109 / L. Frozen platelets CD41, CD42b, CD61, CD62P, CD63, recovery and platelet corrected value (CCI) were measured. Results Transplantation generally need to transfusively stored autologous platelets 2 to 4 times. The recovery of platelets after cryopreservation was between 47% ~ 87%, the average recovery was (72.73 ± 10.49)%. In 22 cases of platelet transfusion, the percentage of platelet CD62P increased after 12 cycles of freezing and thawing, and the percentage of platelet CD63 increased after 7 cycles of freezing and thawing, indicating that platelets appeared A certain degree of activation. In 4 cases, the percentage of platelet CD41 or CD42b decreased after thawing, indicating that platelet adhesion and aggregation function were affected to a certain extent. After CCI in the infusion (5.6 ~ 17.6) × 109 / L, 22 times in 22 times the CCI in the return of 7.5 above. No bleeding occurred during transplantation, and no complications occurred after transfusion. Conclusion The use of cryoautomatic platelet transfusion during hematopoietic stem cell transplantation can prevent the occurrence of bleeding during the transplantation and replace transfusion of allogeneic platelets to prevent transfusion-transmitted diseases such as HIV and cytomegalovirus. The transfusion is safe and safe Practicable.
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