Human-Leucocyte-Antigen-Antikörperbildung unter Hämotherapie
Auch gedruckt in der BibliothekW: W-H 12.857
Ressourcen- / MedientypDissertation, Text
Datum der Freischaltung2012-05-02
Substitution of transfused platelet concentrates are often accused to cause HLA-antibody development. Immunization capability of blood products should have been decreased by universal leukoreduction. Aims: This study should re-assess safety of leukocyte depleted blood products with a special focus on HLA-antibody development. Methods:Analysis of outpatient transfusions, patient characteristics, transfused concentrates. HLA-antibody testing was performed at the beginning and end of the observation period by lymphocyte toxicity test and ELISA of HLA-antibodies class I/II. Results: 74 pts were included in this follow up assessment. Patient characteristics: 41 male, 34 female. 18/34 evaluable female pts had pregnancies in patient history. Underlying diseases: hematopoietic disease (n= 61), solid tumours (n= 9) or a combination of both (n= 4). In summary 968 P-PC , 23 A-PC and 110 HLA-matched A-PC were transfused. Median corrected count increment for platelets was 13130 µl. At the first assessment in 23/74 pts reactive results in LCT and/or ELISA for HLA class I or II-antibodies were obtained. LCT was specific positive with HLA-antibody detection in 10/74 patients and unspecific positive in 2/74 patients. ELISA HLA class I was positive with a score > 2 in 17/50 pts (ELISA HLA-class II in 7 pts). Pts with specific or unspecific positive results in LCT and/or ELISA had in median a transfusion history of 2 RBC and 1 PC. In contrast the pts with normal results in LCT and ELISA had a median of 8 RBC and 5 PC transfused. Diagnoses of the pts with specific HLA-antibodies were all hematopoietic. Antibodies class I were associated with insufficient increment. Conclusion: Our data show the prevalence of HLA-antibodies in multi-transfused patients with hematopoietic disease. Our data do not confirm the thesis of a correlation with the number of transfused units. Therefore new strategies for identification of patients with a high individual immunization risk should be discussed.