Gamma-irradiation of blood products following autologous stem cell transplantation: surveillance of the policy of 35 centers
Gamma-irradiation of blood products following autologous stem cell transplantation: surveillance of the policy of 35 centers
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DOI：
10.1007/s00277-003-0785-z
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发表时间：
2004-01-01
影响因子：
3.5
通讯作者：
Uppenkamp, M
中科院分区：
文献类型：
--
作者：
Weiss, B;Hoffmann, M;Uppenkamp, M
在异基因干细胞移植期间和进行自体干细胞采集之前，应对血液制品进行辐照，以预防急性输血相关移植物抗宿主病（TA-GVHD）。通常，在同种异体环境中，所有血液制品的辐照持续终身。到目前为止，没有广泛接受的规则存在关于自体干细胞移植。我们在这里提出的调查结果发送到47个德国移植中心关于输血政策后自体干细胞移植。包括35个回答中心的结果。在35个中心中，有10个中心为患者提供终身辐照血液制品，主要是为了防止将未经辐照的血液成分错误输注给同种异体接受者。35个中心中有22个在自体干细胞移植后的特殊时间段内管理辐照血液制品。在大多数中心，这一时间跨度为3至6个月。只有少数中心（4/35）将这一时间跨度扩大到移植后1-2年。少数中心（3/35）向其所有患者或未患急性白血病或全身照射（TBI）后的患者提供未照射的血液制品。大多数临床试验机构（19/35）提供辐照血液制品，与预处理方案无关。53%的中心决定捐献不依赖免疫重建的辐照血液制品。但在大多数中心，某种血液重建是终止辐照血液制品的主要标准。64%的中心在基础疾病方面的输血政策没有差异。无临床试验机构发生经证实的TA-GVHD病例。应制定自体干细胞移植后输血政策指南。
Blood products should be irradiated during allogeneic stem cell transplantation and before performing autologous stem cell harvest for prevention of acute transfusion-associated graft-versus-host disease (TA-GVHD). Usually, irradiation of all blood products is continued lifelong in the allogeneic setting. Up to now, no broadly accepted rules exist concerning autologous stem cell transplantation. We present here the results of an inquiry sent to 47 German transplantation centers regarding the transfusion policy following autologous stem cell transplantation. The results of 35 answering centers are included. Ten out of 35 centers offer irradiated blood products lifelong to their patients, mainly for the prevention of mistransfusion of non-irradiated blood components to allogeneic recipients. Twenty-two out of 35 centers administer irradiated blood products for a special time span after autologous stem cell transplantation. In most centers, this time span is from 3 to 6 months. Only few centers (4/35) expand this time span to 1-2 years after transplantation. A minority of centers (3/35) gave non-irradiated blood products to all of their patients or to patients not suffering from acute leukemia or after total body irradiation (TBI) containing preparative regimens. Most centers (19/35) deliver irradiated blood products irrespective of the conditioning regimen. Fifty-three percent of the centers decide to donate irradiated blood products not depending on immunological reconstitution. But in most centers some kind of hematological reconstitution is a major criterion for termination of irradiated blood products. Sixty-four percent of the centers made no difference in transfusion policy in regard to the underlying disease. No center experienced cases of proofed TA-GVHD. Guidelines should be worked out concerning transfusion policy after autologous stem cell transplantation.