PLATELET ALLOIMMUNITY IN MARROW TRANSPLANTATION

此项目将尝试定义、然后阻止、延迟或 血小板输注的反向同种异体免疫。我们会 在移植前评估患者是否有证据表明 基于抗体检测和放射性同位素的同种异体免疫 血小板存活量。非同种免疫的患者将被随机分配 接受常规制备的血液制品或进入两项研究 武器：仅从无关的单一来源输注血小板 捐献者顺序捐献或血小板和红细胞耗尽 白细胞。我们会比较输血要求、反应 与血小板输注和淋巴细胞毒的发展有关 这三组患者均存在血小板抗体。方法将是 开发用于血液产品的紫外线照射(UVI)和 预防与这些产品的同种异体免疫将是 学习。 在选定的血小板抗体阳性的患者中， 移植后，将进行血浆置换以取出 抗体动力学将通过与类似的 未进行血浆置换的同种异体免疫患者组。 如果血浆置换成功，特定的移除方法 抗体通过体外免疫吸收与全血小板结合 被开发出来。

This project will attempt to define, then prevent, delay, or reverse alloimmunization to platelet transfusions. We will evaluate patients prior to transplantation for evidence of alloimmunization based on antibody testing and radioisotope platelet survivals. Nonalloimmunized patients will be randomized to receive routinely prepared blood products or into two study arms: platelet transfusions exclusively from single unrelated donors given sequentially or platelets and red cells depleted of leukocytes. We will compare transfusion requirements, response to platelet transfusions and the development of lymphocytotoxic and platelet antibodies in these three groups. Methods will be developed for ultraviolet irradiation (UVI) of blood products and the prevention of alloimmunization with these products will be studied. In selected patients with antibodies to platelets prior to transplant, plasma exchange will be performed to remove antibodies kinetics will be evaluated by comparison to a similar group of alloimmunized patients who are not plasma exchanged. If plasma exchange is successful, specific methods of removing antibodies by ex vivo immunoabsorption with whole platelets will be developed.