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Objective:To investigate the causes of ineffective platelet transfusion in patients with hematologic malignancies during myelosuppression and the therapeutic effect of rituximab.Methods:A total of 180 patients with different hematologic malignancies in the First People's Hospital of Changzhou from January 2017 to December 2018 were selected. And the incidence of ineffective platelet transfusion during myelosuppression was observed. The changes of T and B lymphocyte subgroups and platelet counts before and after rituximab therapy in acute leukemia patients with platelet antibody-positive were compared, and the incidence of ineffective platelet transfusion with different platelet suspensions was analyzed.Results:The ineffective platelet transfusion was observed in 45 of 180 patients (25.0%) during myelosuppression, including 30 (27.8%) of 108 patients with acute leukemia, 10 (23.3%) of 43 patients with myelodysplastic syndrome, 2 (13.3%) of 15 patients with malignant lymphoma, and 3 (21.4%) of 14 patients with multiple myeloma. The incidence of ineffective platelet transfusion in patients transfused with irradiated leukocyte depleted apheresis platelets (17.0%, 16/94) was lower than that in those with apheresis platelets (33.7%, 29/86), and the difference was statistically significant (χ 2 = 6.68, P = 0.01). In 8 acute leukemia patients with platelet antibody-positive and the ineffective platelet transfusion after rituximab therapy, the increase of platelet count was observed in 5 patients. The differences of levels of CD19, CD20, CD4 and platelet count before and after treatment with rituximab were statistically significant (all P < 0.05). Conclusions:The incidence of ineffective platelet transfusion is the highest in acute leukemia patients. Transfusion of human leukocyte antigen-matched platelets can improve the effect of platelet transfusion. Rituximab is effective in the ineffective platelets transfusion caused by immune factors. The incidence of ineffective platelet transfusion in irradiated leukocyte depleted apheresis platelets is lower compared with that in apheresis platelets.
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Objective@#To investigate the causes of ineffective platelet transfusion in patients with hematologic malignancies during myelosuppression and the therapeutic effect of rituximab.@*Methods@#A total of 180 patients with different hematologic malignancies in the First People's Hospital of Changzhou from January 2017 to December 2018 were selected. And the incidence of ineffective platelet transfusion during myelosuppression was observed. The changes of T and B lymphocyte subgroups and platelet counts before and after rituximab therapy in acute leukemia patients with platelet antibody-positive were compared, and the incidence of ineffective platelet transfusion with different platelet suspensions was analyzed.@*Results@#The ineffective platelet transfusion was observed in 45 of 180 patients (25.0%) during myelosuppression, including 30 (27.8%) of 108 patients with acute leukemia, 10 (23.3%) of 43 patients with myelodysplastic syndrome, 2 (13.3%) of 15 patients with malignant lymphoma, and 3 (21.4%) of 14 patients with multiple myeloma. The incidence of ineffective platelet transfusion in patients transfused with irradiated leukocyte depleted apheresis platelets (17.0%, 16/94) was lower than that in those with apheresis platelets (33.7%, 29/86), and the difference was statistically significant (χ2 = 6.68, P = 0.01). In 8 acute leukemia patients with platelet antibody-positive and the ineffective platelet transfusion after rituximab therapy, the increase of platelet count was observed in 5 patients. The differences of levels of CD19, CD20, CD4 and platelet count before and after treatment with rituximab were statistically significant (all P < 0.05).@*Conclusions@#The incidence of ineffective platelet transfusion is the highest in acute leukemia patients. Transfusion of human leukocyte antigen-matched platelets can improve the effect of platelet transfusion. Rituximab is effective in the ineffective platelets transfusion caused by immune factors. The incidence of ineffective platelet transfusion in irradiated leukocyte depleted apheresis platelets is lower compared with that in apheresis platelets.
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Objective To study the level of the Toll like-receptor mRNA expression on PBMCs from patients with the idiopathic thrombocytopenic purpura.Methods We performed quantitative real-time reverse transcription-polymerase chain reaction(SYBR Green Ⅰ fluorescent dye combination technique)analyses of PBMCs from 30 idiopathic thrombocytopenic purpura(ITP) patients and 30 healthy subjects,to estimate the relative levels of TLR2,TLR4,TLR6,TLR7 and TLR9 mRNA expression.Results Relative expression levels of TLR2 and TLR7 mRNAs in ITP group(n=30)were significantly higher than those in health control group(n=30)(P0.05).Conclusion Expressions of TLR2 and TLR7 mRNA are up-regulated in patients with ITP,which may play an important role in the pathogenesis of ITP.
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Objective To induce CD4+CD25+ regulatory T lymphocytes from mononuclear cells of rhG-CSF mobilized peripheral blood,and to analyze the phenotype and function of them.Methods Blood samples of ten donors of peripheral blood stem cell were collected,CD4+CD25–T lymphocytes from rhG-CSF mobilized peripheral blood(G-PB group) and unmobilezed peripheral blood(PB group) were isolated with a CD4+CD25+T lymphocytes selection kit,and then were induced by TGF-?1.FCM,RT-PCR,cell proliferration and suppression assay were used to test the expression of CD25+,Foxp3 and suppressive function,and the difference of the rate and the suppressive activity of CD4+CD25+T cells were compared.Results 1) After treated with anti-CD3mAb and TGF-?1,there was a difference between CD4+CD25–T lymphocytes isolated from G-PB group and PB group,the expression of CD25+ were(77.9?2.3)% and(65.7?4.2)%,respectively(P
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ObjectiveTo observe the relationship between HPA-1—5,6,15 alleles and idiopathic thrombocytopenic purpura.MethodsPolymerase chain reaction-specific sequence primers(PCR-SSP) was used to genotype HPA-1-5,6,and 15 in the ITP group(n=25) and the health control group(n=25).The platelet adsorbed and free antibodies in the two groups were detected by ELISA and microcolumn gel immunoassay.ResultsThe allele frequencies of HPA-3 was significantly different between the ITP group and control group(P0.05).The platelet free antibodies were detected in 17 ITP samples(68%) and the adsorbed antibodies were detected in 21 ITP samples(84%).No platelet antibodies were detected in the control group.ConclusionThere was a possible association between the HPA-3 allele and ITP.The detection rate of platelet adsorbed antibodies is significant higher than that of platelet free antibodies.