恶性肿瘤患者红细胞同种免疫评价分析

Evaluation analysis on red cell alloimmunization of malignant tumor patients

目的:通过分析恶性肿瘤患者红细胞同种抗体分布、是否发生输血反应及其与年龄、疾病状态等因素的关系来评价恶性肿瘤患者红细胞同种免疫状况。方法:对3 172例输血的恶性肿瘤患者用全自动分析仪进行红细胞同种抗体筛查,对筛查阳性者进一步鉴定其特异性,然后分析红细胞同种抗体类别及产生患者输血史、妊娠史、年龄、疾病状态、是否发生输血反应等。结果:在3 172例输血的恶性肿瘤患者中共检出7例红细胞同种抗体,发生率约为0.22%,其中RH系统4例(3例抗-E、1例抗-cE)占57%,MNS系统2例(均为抗-M),约占29%,Lewis系统1例(抗-Lea),约占14%;恶性肿瘤早期和中期各有4例和3例;40~50岁年龄组4例,其他年龄组各1例;7例患者均有输血史或(和)妊娠史;输血前后均未发生输血反应。结论:恶性肿瘤患者红细胞同种免疫发生率较低,这可能与患者的年龄、疾病状态及所接受的治疗等因素相关;产生的红细胞同种抗体以有临床意义的抗Rh类抗体为主。

Objective：To evaluate red blood cell alloimmunization status of the patients with malignant tumors by analyzing the correlation between alloantibody distribution,occurrence of transfusion reaction,age and disease progression.Method：Alloantibodies of 3 172 patients with malignant tumors were screened by automated analyzer and the specificity of antibody detected in positive cases was identified.The presence and type of red cell alloantibody,blood transfusion history,pregnancy history,age,disease progression and transfusion reaction were analyzed.Result：Seven cases of alloantibodies were detected out of 3 172 malignant tumor patients,the incidence rate was 0.22%.Four cases（57%）were from Rh system（3case of anti-E,1case of anti-cE）,2cases（29%）from MNS system（all anti-M）,and 1case（14%）from Lewis system（anti-Lea）.In these 7cases,4cases occurred in early-stage malignant tumors and 3cases in mid-stage malignant tumors.Four cases were found in the age group40 to 50and 1each in the other age groups.All 7patients had a transfusion history and/or pregnancy history and no transfusion reaction was observed before or after this transfusion.Conclusion：Red blood cell alloimmunization has a low incidence rate in patients with malignant tumors.It could depend on age,disease progression and treatment received.The red blood cell alloantibodies are almost clinical significant anti-Rh.