【摘要】 目的观察冷冻保存自体血小板输注式造血干细胞移植的临床效果。方法在8例造血干细胞移植过程中进行了22例次冷冻保存自体血小板回输。采用COBE单采机采集血小板,加5%二甲亚砜(DMSO)血小板冻存保护剂,置-80℃冰箱冷冻保存1~3个月。40℃水浴复苏冻存血小板。血小板<20×109/L时回输冻存血小板。测定冻存血小板CD41、CD42b、CD61、CD62P、CD63、回收率及血小板校正增加值(CCI)。结果移植后一般需输注冻存自体血小板2~4次。血小板冻存后回收率在47%~87%之间,平均回收率为(72.73±10.49)%。在22例次血小板冷冻保存回输中,流式细胞仪测定发现有12例次冻融后的血小板CD62P百分比值升高,7例次冻融后的血小板CD63百分比值升高,表明血小板出现了一定程度的活化。有4例次冻融后的血小板CD41或CD42b百分比值减低,表明血小板的黏附聚集功能受到一定程度的影响。输注后CCI在(5.6~17.6)×109/L之间,22次回输中有18次的CCI在7.5之上。移植过程中无出血发生,回输后也未出现并发症。结论造血干细胞移植时采用冻存自体血小板输注可以防止移植过程中出血的发生,代替异体血小板输注而杜绝诸如艾滋病毒、巨细胞病毒等造成的输血传播性疾病的发生,回输是安全和切实可行的。更多还原

【Abstract】 Objective To explore the effect of autologous cryopreserved platelet transfusions in hemotologic malignancies receiving hemopoietic stem cell transplantation. Methods 22 platelet-infusions of 8 cases were studied. Autologous platelets were cryopreserved in 5% dimethylsulfoxide, stored at-80℃ for 1 to 3 months,and thawed in a 40℃ water bath ,transfused when platelet counts dropped below 20 x 109/L. In vitro studies of cryopreserved platelets (CD41、CD42b 、CD61 、CD62p、CD63 、median loss during the freeze-thaw-wash procedure and a corrected count increment )CCI were performed. Results The times of platelets reinfused was at range 2~4. platelet recovery after freezing and thawing was 47%~87% and the mean recovery(72.73±10.49)%. The values of CD62p ,CD63 increased in respectively 12 and 7 infusions, The values of CD41or (and) CD42b decreased in 4 infusions by flow cytometric method.Autotransfusions could maintain platelet count above 20×109/L with a corrected count increment >7.5 in 18 infusions. Conclusions Our data demonstrate that autotransfusions of platelets can be safely administered to support the period of thrombocytopenia in patients undergoing hemopoietic stem cell transplantation. Autologous cryopreserved platelet transfusions in these patients can abrogate the risks such as AIDS and CMV infections deriving from allogeneic platelet transfusion.It was found to be a safe and effective procedure.更多还原