PLATELET ALLOIMMUNITY IN MARROW TRANSPLANTATION

这个项目将试图定义，然后防止，延迟，或 逆转同种异体免疫至血小板输注。 我们将 在移植前对患者进行评估， 基于抗体检测和放射性同位素的同种免疫 血小板存活率。 非同种免疫患者将随机分组 接受常规制备的血液制品或两项研究 组：血小板输注仅来自单个无关 连续给予或血小板和红细胞耗尽的供体 白细胞 我们将比较输血需求、反应 血小板输注和淋巴细胞毒性 和血小板抗体。 方法将 开发用于血液制品的紫外线照射（UVI）， 用这些产品预防同种异体免疫， 研究了 在选定的血小板抗体患者中， 移植，将进行血浆置换， 抗体动力学将通过与类似的 未进行血浆交换的同种免疫患者组。 如果血浆置换成功， 通过用完整血小板进行离体免疫吸收的抗体将 发展。

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.