TRANSFUSION TRIAL TO PREVENT PLATELET ALLOLIMMUNIZATION

针对组织相容性抗原的同种异体免疫发生在30%-50% 急性非淋巴细胞白血病患者并可包括分娩 有可能治愈的缓解后疗法。有很多种 减少这种发病率的潜在方法，其相对优点是 都在这份拨款提案中进行了讨论。马里兰大学癌症分校 中心(UMCC)有兴趣并准备参与随机化 比较这些不同输血方法的临床试验 集聚浓缩血小板标准方法的实践 随机捐赠者。UMCC是一个很好的开展 这类研究的原因如下：(1)有很好的文献记载 30-40例急性非淋巴细胞白血病新患者的可获得性 适用于研究/年度；(2)相同的调查人员负责 白血病和输血服务保证了高度的 合规性和随机化；(3)UMCC已进行并发布 输血支持护理和血小板领域的多项研究 免疫学；这些研究包括一些随机研究，其中之一 这是一项随机试验，使用去白细胞的血小板来改变 同种异体免疫率；(4)UMCC在 合作的癌症治疗小组，并拥有多年的设施 收集和转移研究数据的经验；此外 UMCC目前将所有的血小板输注结果输入到计算机化的 用于临床和研究目的并具有潜在适应性的数据库 在本RFA中使用；(5)本提案的两名调查人员均担任主席 并分析了国家组临床治疗试验和P.I. 目前担任B组癌症和白血病委员会主席。 与巴尔的摩Rh打字实验室签订的分包合同 进行淋巴细胞毒性抗体筛查的参考实验室是 作为UMCC提案的补充提交。

Alloimmunization against histocompatibility antigens occurs in 30-50% of patients with acute non-lymphocytic leukemia and can comprise the delivery of potentially curative post remission therapy. There are a number of potential means of decreasing this incidence, the relative merits of which are discussed in this grant proposal. The University of Maryland Cancer Center (UMCC) is interested in and prepared to participate in randomized clinical trials to compare these various modification of transfusion practice to the standard approach of pooled platelet concentrates from random donors. The UMCC is an excellent environment in which to conduct such studies for the following reasons: (1) there is a well-documented availability of 30-40 new patients with acute non-lymphocytic leukemia suitable for study/annum; (2) the same investigators are responsible for the leukemia and transfusion services guaranteeing a high degree of compliance and randomization; (3) the UMCC has conducted and published multiple studies in the area of transfusion supportive care and platelet immunology; these have included a number of randomized studies, one of which was a randomized trial using leucocyte depleted platelets to modify the rate of alloimmunization; (4) the UMCC has extensive experience in cooperative cancer treatment groups and has facilities for and years of experience with collection and transfer of research data; in addition the UMCC currently enters all platelet transfusion results into a computerized data base used for clinical and research purposes and potentially adaptable for use in this RFA; (5) both investigators on this proposal have chaired and analyzed national group clinical treatment trials and the P.I. currently chairs the Leukemia Committee of the Cancer and Leukemia Group B. A subcontract with the Baltimore Rh Typing laboratory to serve as a reference laboratory to perform lymphocytotoxic antibody screens is submitted as a supplement to the UMCC proposal.