摘要
目的:监测ABO血型不合造血干细胞移植患者IgM型和IgG型ABO血型抗体的变化,研究这些变化在移植患者血型转变中的作用。方法:用凝聚胺法和微柱凝胶法监测32例移植患者ABO血型,IgM型和IgG型ABO血型抗体的变化。结果:32例ABO血型不合患者血型全部转变为供者型,造血重建时间结果分析表明血型不合对于粒系和血小板的恢复无影响;患者血型转为供者血型后,其血清中缺乏相对应的抗体;32例ABO血型不合患者中有6例供受者移植模式为A→O,其中有3例发生PRCA,且均检出IgG型抗A抗体,其余29例未检测到IgG血型抗体;3例PRCA患者红系造血恢复时间明显延长。结论:IgG型ABO血型抗体可能会抑制ABO血型不合骨髓移植患者的红系分化成熟,在PRCA的发生中可能起重要作用。监测ABO血型不合移植患者体内的ABO血型抗体变化可指导输血治疗,避免溶血性输血反应。
Objective ： To monitor the changes of IgG and IgM ABO blood group antibody in patients with ABO-imcompatible allogeneic hematopoietic stem cell transplantation （allo-HSCT）, and to investigate the effects of above changes during the patients＇ blood group conversion. Methods： The changes of ABO blood group, IgM and IgG antibody from 32 patients who underwent ABO-imcompatible allo-HSCT were detected by polybrene and microcolumn gel technique. Results ： ABO Blood group of all 32 patients switched to donor blood group, and analysis of hematopoietie reconstruction time showed that ABO-imcompatibility had no effects on recovering of granulocytes and thrombocytes. After patient＇s blood group converting to donor＇s blood group, corresponding antibodies against donor and recipient RBCs in patient were undetectable. There were 6 cases out of 32 patients underwent ABO-imcompatible alIo-HSCT which transplant modes were A donor to O mode, and 3 patients whose IgG-type anti-A could be detected from the 6 cases, developed pure red cell aplasia （PRCA）, while the other 29 patients could not be detected. Recovery time of erythropoietie system in 3 patients with PRCA was prolonged obviously. Conclusion： ABO antibody of IgG-type may play an important role in developing of PRCA, for which could restrain differentiation and maturation of erythropoietic system. Monitoring the changes of patient＇s ABO antibody could guide transfusion therapy and avoid hemolytic transfusion reaction.
出处
《陕西医学杂志》
CAS
2009年第11期1480-1483,共4页
Shaanxi Medical Journal
基金
广东省医学科研基金资助项目(No.A2007242)
关键词
红细胞再生障碍
纯/血液
血型不合ABO血型系统
造血干细胞移植
输血
Red cell aplasia,pure/blood Blood group incompatibitity ABO blood-group system Hemmatopotetic stem cell transplantation Blood transfusion
