PLATELET ALLOIMMUNITY IN MARROW TRANSPLANTATION

骨髓移植中的血小板同种免疫

• 批准号: 3938016
• 负责人: WILLIAM I BENSINGER
• 金额: --
• 依托单位: FRED HUTCHINSON CANCER RESEARCH CENTER
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/3938016
• 关键词: antileukocyte isoantibody; blood donor; bone marrow transplantation; cell mediated cytotoxicity; cellular immunity; chronic disease /disorder; delayed hypersensitivity; fibrinogen; flow cytometry; histocompatibility typing; human subject; immunoglobulins; immunosuppression; leukocyte antigen typing; major histocompatibility complex; myelogenous leukemia; neoplasm /cancer immunotherapy; platelet transfusion; plateletpheresis; radioimmunoassay; radiotracer; remission /regression; ultraviolet radiation

This project will attempt to define, then prevent, delay, or reverse alloimmunization to platelet transfusions. We will evaluate patients prior to transplantation for evidence of alloimmunization based on antibody testing and radioisotope platelet survivals. Nonalloimmunized patients will be randomized to receive routinely prepared blood products or into two study arms: platelet transfusions exclusively from single unrelated donors given sequentially or platelets and red cells depleted of leukocytes. We will compare transfusion requirements, response to platelet transfusions and the development of lymphocytotoxic and platelet antibodies in these three groups. Methods will be developed for ultraviolet irradiation (UVI) of blood products and the prevention of alloimmunization with these products will be studied. In selected patients with antibodies to platelets prior to transplant, plasma exchange will be performed to remove antibodies kinetics will be evaluated by comparison to a similar group of alloimmunized patients who are not plasma exchanged. If plasma exchange is successful, specific methods of removing antibodies by ex vivo immunoabsorption with whole platelets will be developed.

该项目将尝试定义、然后阻止、延迟或 逆转血小板输注的同种免疫。 我们将 移植前评估患者的证据 基于抗体检测和放射性同位素的同种免疫 血小板存活率。 未同种免疫的患者将被随机分组 接受常规制备的血液制品或参加两项研究 臂： 血小板输注完全来自单一无血缘关系的人 连续给予的捐赠者或血小板和红细胞耗尽的捐赠者 白细胞。 我们将比较输血要求、反应 血小板输注和淋巴细胞毒性的发展 和这三组中的血小板抗体。 方法将是 专为血液制品的紫外线照射（UVI）而开发 使用这些产品预防同种免疫反应将是 研究过。 在选定的患者中，在治疗前具有血小板抗体 移植，将进行血浆置换以去除 抗体动力学将通过与类似的比较来评估 未进行血浆交换的同种免疫患者组。 如果血浆置换成功，去除的具体方法 通过全血小板离体免疫吸收产生的抗体将 得到开发。