Replaced platelet concentrates containing a new additive solution, M-sol: safety and efficacy for pediatric patients.
Replaced platelet concentrates containing a new additive solution, M-sol: safety and efficacy for pediatric patients.
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含有新添加剂溶液 M-sol 的替代血小板浓缩物：对儿科患者的安全性和有效性。
DOI：
10.1111/trf.12025
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发表时间：
2012
期刊：
影响因子：
--
通讯作者：
Sakashita K
中科院分区：
文献类型：
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作者：
Yanagisawa R;Sakashita K
背景：变态反应(ATRs)，尤其是富含血浆的浓缩血小板(P-PC)引起的变态反应，是输血医学关注的重要问题。用含有M-Sol的PC(M-Sol-R-PC)取代P-PC有望防止ATR。然而，这还没有得到足够的临床证据的证实。研究设计和方法在2008-2011年间进行了一项回溯性队列研究。在2010至2011年间，对患有血液病、实体瘤、原发免疫缺陷疾病或遗传性代谢障碍的儿童患者输注M-Sol-R-PC；对2008至2011年间输注P-PC的ATRs频率和严重程度、校正计数增量(CCI)和出血发生率进行比较。结果2008-2011年间，接受515例P-PC输注的78例患者中，14例(17.9%)有17例ATR(3.3%)，14例和3例ATR分别为1级和2级。2010年至2011年，49名患者接受了620次M-Sol-R-PC输血，2名患者(4.1%)出现了1级ATR(0.3%)。因此，在两次输血中，每袋和每名患者的ATRs频率显著不同。M-Sol-R-PC组未使用任何类固醇药物预防或治疗ATRS。M-Sol-R-PC与P-PC的CCI(24 hr)无差异。结论M-Sol-R-PC可有效预防儿童ATRS，且不损失输血效率，但其疗效有待于前瞻性临床试验进一步评价。
BackgroundAllergic transfusion reactions (ATRs), particularly those caused by plasma‐rich platelet concentrates (P‐PCs), are an important concern in transfusion medicine. Replacing P‐PCs with PCs containing M‐sol (M‐sol‐R‐PCs) is expected to prevent ATRs. However, this has not yet been verified by sufficient clinical evidence.Study Design and MethodsA retrospective cohort study was performed between 2008 and 2011. Pediatric patients with hematologic disorders, solid tumors, primary immunodeficiency disorders, or inherited metabolic disorders were transfused with M‐sol‐R‐PCs between 2010 and 2011; the transfusions of P‐PCs administered between 2008 and 2011 were compared in terms of frequency and severity of ATRs, corrected count increment (CCI), and occurrence of bleeding. Data were collected for 6 consecutive months on a per‐patient basis.ResultsData obtained during 2008 to 2011 showed that of the 78 patients receiving 515 P‐PC transfusions, 14 (17.9%) had 17 ATRs (3.3%); 14 and three ATRs were of Grades 1 and 2, respectively. In 2010 to 2011, 49 patients received 620 transfusions of M‐sol‐R‐PCs, and two patients (4.1%) had Grade 1 ATRs (0.3%). Thus, the frequency of ATRs per bag and per patient differed significantly between the two transfusions. No steroid agents were used for the prevention or treatment of ATRs in the M‐sol‐R‐PC group. The CCI (24 hr) for M‐sol‐R‐PCs did not differ from that for P‐PCs.ConclusionM‐sol‐R‐PCs were found to be effective in preventing ATRs without loss of transfusion efficiency in children; however, its efficacy should be further evaluated in prospective clinical trials.