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%的 急性非淋巴细胞白血病患者，并可包括递送 缓解后治疗的潜在疗效。有许多 降低这种发生率的潜在方法，其相对优点是 都在这份拨款申请中讨论。马里兰州癌症大学 中心（UMCC）有兴趣并准备参加随机化 临床试验来比较这些不同的输血方法 标准方法的实践， 随机捐赠者UMCC是一个很好的环境， 这类研究的原因如下：（1）有一个良好的记录， 30-40名急性非淋巴细胞白血病新患者的可用性 适合研究/年;（2）相同的研究者负责 白血病和输血服务保证了高度的 （3）UMCC已进行并公布了 输血支持治疗和血小板输注领域的多项研究 免疫学;这些研究包括一些随机研究，其中一项 这是一项随机试验，使用白细胞减少的血小板来改变 同种免疫率;（4）UMCC在以下方面具有丰富的经验： 合作的癌症治疗小组，并有设施和多年的 收集和转移研究数据的经验;此外， UMCC目前将所有血小板输注结果输入计算机 用于临床和研究目的的数据库， 用于本RFA;（5）本提案的两位研究者均主持了 并分析了国家组临床治疗试验和P.I. 目前担任癌症和白血病小组B的白血病委员会主席。 与巴尔的摩Rh分型实验室合作， 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.