肿瘤患者血小板相关抗体分析

Analysis of platelet-associated antibodies among cancer patients

目的分析肿瘤患者血小板相关抗体产生规律及临床意义,探寻肿瘤患者临床血小板输注无效对策。方法先用ELISA方法QUIKSCREEN试剂筛查反复输注血小板3次以上肿瘤患者的HLA IgG抗体,再将初筛阳性样本用PAKPLUS试剂确定HLA、HPA抗体,同时观察抗体阳性患者临床症状并判断输注疗效。结果116份样本中筛查出HLA IgG抗体44例,抗体阳性率37.93%。初筛阳性样本经检测确认HLA抗体18例,HPA抗体8例,未能确认8例,其中HPA抗体及HLA抗体同时阳性10例。抗体阳性率与血小板输注次数成正相关(P<0.01),且与输注效果之间的相关性有统计学意义(P<0.01)。结论肿瘤患者血小板抗体阳性率与血小板输注次数相关,且与输注效果有关。

Objectives To analyze the mechanisms and implications involved in the generation of platelet associated antibodies in cancer patients. Methods HLA IgG antibody from 116 cancer patients who had received repeated platelet transfusion （ more than 3 times） was screened by the GTI QUICKSCREEN kit. The positive samples from the initial screening were confirmed for HLA and HPA antibodies using the PAKPLUS reagent. Patients with antibodies were observed for symptoms and clinical effectiveness of platelet transfusions. Results A total of 44 cases of HLA IgG antibody were screened out of 116 samples, with an antibody rate of 37.93%. Among those 44 samples, 18 were confirmed to contain anti-HLA- I antibody, 8 with anti-HPA antibody, 10 with both anti-HPA and anti-HLA antibodies, and 8 were not identified. The occurrence of antibodies was positively correlated to the times of platelet transfusions and con-elated to the improvement of clinical symptoms （P 〈0. 01 ）. Conclusion This study characterized the platelet antibodies among cancer patients. Results from this study suggest that the factors affecting antibody production shall be considered to ensure effective platelet transfusion.