Alloantibody responses in multiply transfused sickle cell patients.
Alloantibody responses in multiply transfused sickle cell patients.
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多次输血镰状细胞患者的同种抗体反应。
DOI：
10.1111/j.1399-0039.1987.tb01615.x
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发表时间：
1987
期刊：
影响因子：
--
通讯作者：
Dawson,DV
中科院分区：
文献类型：
--
作者：
Reisner,EG;Kostyu,DD;Phillips,G;Walker,C;Dawson,DV
对56例成人和15例儿童镰状细胞病患者进行了红细胞反复输注后的抗体检测。对红细胞抗体进行回顾测定；对最近提取的单个血液样本进行抗淋巴细胞抗体(I类和II类)测定。所有成人均为人类白细胞抗原-A、B、C、DR和DQ型。在输血少于50次的个体中，有10%的人有红细胞抗体，但在输血100次或以上的个体中，有超过50%的人有红细胞抗体。产生抗红细胞抗体的患者的百分比随着输血次数的增加而持续增加(p=0.0062)。女性比男性更有可能对红细胞抗原敏感(p=0.008)，而未分娩的女性比经产的女性更有可能。儿童对红细胞抗原的敏感率为20%，对淋巴细胞抗原的敏感率为73%。未发现与红细胞致敏倾向增加的人类白细胞抗原相关。人类白细胞抗原DR5和DR7与淋巴细胞同种异体抗原不能致敏的相关性较弱，但无统计学意义。我们的结果表明，虽然影响输血反应的遗传因素几乎肯定存在，但需要检查其他因素，如输血次数、年龄、性别和产次，以提供对慢性输血风险的准确预测。
Fifty‐six adult and 15 pediatric black patients with sickle cell disease were studied to determine their antibody responses to repeated transfusions of red cells. Red cell antibodies were determined restrospectively; anti‐lymphocyte antibodies (class I and II) were determined on the single, most recently drawn blood sample. All adults were HLA‐A, B, C, DR and DQ typed.Ten percent of the individuals with less than 50 transfusions, but greater than 50% with 100 transfusions or more, had red cell antibodies. The percentage of patients producing anti‐red cell antibodies increased consistently with the number of transfusions (p = 0.0062). Women were more likely to become sensitized to red cell antigens than men (p = 0.008), and nulliparous women more likely than multiparous women. Children were also sensitized to red cell antigens (20%), and to a high degree to lymphocyte antigens (73%). No HLA association was found with increased propensity to red cell sensitization. A weak association of HLA DR5 and DR7 with failure to become sensitized to lymphocyte alloantigens was observed, but did not reach statistical significance. Our results suggest that, while genetic factors influencing transfusion response almost certainly exist, other factors such as number of transfusions, age, sex and parity need to be examined to provide accurate projections of risk in chronic transfusion.