As allogeneic blood transfusion plays a role in clinical treatment effects, it also produces a number of immune-related side effects, such as the increased rate of postoperative infection, the rising relapse rate of malignant resection and so on. All those factors, such as CD200 surface molecule of allogeneic mononuclear cells, interleukin, sHLA and sFasL which are detached from the leukocyte surface during the period of storage, and serum bioactive molecules related to a certain degree with the occurrence of transfusion-related immunomodulation (TRIM). The clinical controlled trials, laboratory researches and animal models demonstrated that cloning deletion, induction of anergy and immune suppression are the three major mechanisms of TRIM. In this article, the research advances on mechanism of TRIM and the mediators inducing TRIM are reviewed.
Animals ; Humans ; Immunomodulation ; Immunosuppression ; Platelet Transfusion ; adverse effects ; Transfusion Reaction

OBJECTIVE: To investigate the pathogenesis and clinical diagnosis of fetal/neonatal alloimmune thrombocytopenia (FNAIT) and analyze the laboratory test results and clinical data related to the disease, so as to provide reference for clinical treatment and improvement of prognosis. METHODS: The clinical data of six neonatal patients with FNAIT in the Neonatology Department of our hospital from March 2017 to September 2020 were retrospectively analyzed, which included laboratory diagnosis, clinical symptoms, treatment, and prognosis. RESULTS: Among six patients, two cases occurred in the first pregnancy and four cases in the second pregnancy. The platelet count of six cases were decreased at admission or during hospitalization and maternal and neonatal serum autoimmune platelet antibody tests were positive. Five cases were accompanied by different degrees of skin and facial bleeding spots or petechiae and ecchymosis, intracranial hemorrhage. Four cases were treated with immunoglobulin and/or steroid hormone therapy (one of them received cross-matched platelets transfusion), while the symptoms of the other two cases improved spontaneously. Five cases recovered and were discharged from the hospital, while one case had not recovered but the family members requested to be discharged forwardly. Four cases were hospitalized within two weeks, but two cases were hospitalized for more than two weeks due to other diseases or factors (e.g., neonatal sepsis, neonatal enteritis, congenital heart disease, neonatal asphyxia, etc.). CONCLUSION FNAIT is characterized by decreased platelet count, with or without bleeding symptoms, and may occur in the first and following pregnancy. FNAIT can recover spontaneously or have a good prognosis after treatment. However, the complication with other diseases or factors may affect the prognosis.
Adult ; Aged ; Antigens, Human Platelet ; Data Analysis ; Female ; Hemorrhage ; Humans ; Infant, Newborn ; Middle Aged ; Platelet Count ; Platelet Transfusion/adverse effects* ; Pregnancy ; Retrospective Studies ; Thrombocytopenia, Neonatal Alloimmune/therapy*

Platelet additive solutions (PAS) can partly or fully substitute blood plasma during platelet storage in normal air temperature. There are some advantages such as avoiding transfusion of large volume of plasma with possible adverse reactions and circulatory overload, saving plasma for other purposes, improving storage conditions, maintaining the viability and haemostatic function of platelet at normal level, and making it easy to inactivate pathogens. There has been an increasing interest in the study of PAS in the past 20 years, the compositions of different PAS have been reported one after another, and the protective effects of PAS on platelets have become better and better. This article focuses on the advances of studies of the composition of PAS, the functions of the different compositions and platelet quality in vitro and in vivo after storage.
Acetates ; pharmacology ; Blood Platelets ; Blood Preservation ; methods ; trends ; Citrates ; pharmacology ; Glucose ; pharmacology ; Humans ; Platelet Transfusion ; adverse effects ; methods

Dengue fever (DF) has several hematological manifestations including thrombocytopenia and increased bleeding risk. Prophylactic platelet transfusion-in the absence of major bleeding-is utilized in DF with thrombocytopenia with the intention of preventing hemorrhagic complications. However, prophylactic platelet transfusion in DF is neither standardized nor supported by clinical evidence. We conclude that risks, costs and poor resource utilization associated with prophylactic platelet transfusion in DF far outweigh any potential hematological benefit, and as such, should not constitute routine clinical practice.
Dengue ; complications ; therapy ; Hemorrhage ; etiology ; prevention & control ; Humans ; Platelet Transfusion ; adverse effects ; economics ; Thrombocytopenia ; etiology ; prevention & control

This study was purposed to investigate the effectiveness of bacterial screening with 24 hours holding in preventing and controlling bacterial contamination of platelets. Bacterial screening of apheresis platelets preserved for 24 hours was performed by using BacT/ALERT automatic bacterial culture system. The samples from 5 bags of platelet were taken in aseptic condition and were merged into 1 bag. The final sample was inoculated into aerobic and anaerobic bottle respectively for testing, meanwhile the screened platelet samples were held for 24 hours. If the platelets were cultured for 24 hours and identification of bacterial strains showed negative, the platelets could be released, and the original platelet samples should be rescreened if initiate positive was found. The results showed that in screening 8017 samples of apheresis platelets the initiate positive results were 16 (0.2%) and confirmed positive were 4 (0.05%). Out of 4 confirmed positive strains, three were Staphylococcus aureus and another was Staphylococcus auricularis. It is concluded that it is necessary for blood center to apply the method of bacterial screening of platelet with 24 hours holding as conventional screening method, which is an effective and feasible way to prevent and control bacterial contamination of platelets.
Bacteria ; isolation & purification ; Bacterial Infections ; prevention & control ; Bacteriological Techniques ; instrumentation ; Blood Platelets ; microbiology ; Blood Preservation ; methods ; standards ; Humans ; Platelet Transfusion ; adverse effects ; Plateletpheresis ; instrumentation

Heparin-induced thrombocytopenia (HIT) is a relatively infrequent complication of heparin administration. HIT can cause devastating thrombosis, making it one of the most serious adverse drug reactions encountered in clinical practice. We successfully treated a case of severe HIT presenting with thrombosis and life-threatening bleeding complications with intravenous immunoglobulin (IVIG), platelet transfusion and oral anticoagulant Rivaroxaban. In this case, we considered that IVIG played the most important role by preventing further thrombosis, increasing the platelet count, and ensuring the efficacy of Rivaroxaban. We therefore suggest that IVIG might be the optimal treatment for patients with this urgent condition.
Aged, 80 and over ; Female ; Heparin ; administration & dosage ; adverse effects ; Humans ; Immunoglobulins, Intravenous ; administration & dosage ; Platelet Transfusion ; Rivaroxaban ; administration & dosage ; Thrombocytopenia ; chemically induced ; therapy

In order to get clinical information about safety and feasibility of successively double autologous hemopoietic stem cell transplants (SD-AHSCT) in malignant hematological disease patients, the complications and hematological reconstitution after SD-AHSCT in 20 patients were analyzed retrospectively. 20 patients with hematologic malignancies received autologous peripheral blood stem/progenitor cell transplantation at the first transplant, and then were given autologous bone marrow transplantation as the second transplant at 4-10 months. The results showed that all the patients tolerated mobilization and collection of peripheral blood stem/progenitor cells as well as bone marrow collection. All the patients got enough hematological stem/progenitor cells for SD-AHSCT and achieved hematological reconstitution after SD-AHSCT. The speed of hematological reconstitution was positively correlated with the transfused quantity of hematological stem/progenitor cells (r = 0.968). The hematological reconstitution after the first autologous hemopoietic stem cell transplant (AHSCT) was earlier than that of the second (P < 0.05). There was no statistical difference between the first and the second AHSCT for the incidence of skin or mucous membrane bleeding (P > 0.05). No patients occurred massive hemorrhage during SD-AHSCT. The quantity of platelet transfusion in the second AHSCT was larger than that in the first AHSCT (P < 0.01). The incidence of oral ulcer in the first AHSCT was significantly higher than that in the second (P < 0.01). No statistical difference between the first and the second AHSCT was there in infectious sites, infectious pathogens and infection incidence (P > 0.10). All the complications were improved or cured, and no patients died of SD-AHSCT complications. In conclusion, SD-AHSCT is safe and feasible, and worthy to be further popularized.
Adolescent ; Adult ; Female ; Hematologic Neoplasms ; surgery ; Hematopoietic Stem Cell Transplantation ; adverse effects ; methods ; Humans ; Male ; Oral Ulcer ; etiology ; Peripheral Blood Stem Cell Transplantation ; adverse effects ; methods ; Platelet Transfusion ; statistics & numerical data ; Reproducibility of Results ; Retrospective Studies ; Transplantation, Autologous

This study was aimed to observe and analyze the effectiveness of platelet transfusion. The platelet count of 1786 patients before transfusion and on 20-24 hours after transfusion was determined by using Auto-Hematology Analyzer, the percent platelet recovery (PPR) was calculated, the platelet transfusion efficiency (PTE) was evaluated by PPR and hemorrhage presentation after platelet transfusion, and the PTE was statistically analyzed according to disease cause, transfusion frequency, platelet type and once transfusion amount. The results showed that the total PTE of 1786 patients was 52.5%. The comparison of PTE among groups of disease cause showed that PTE in leukemia and aplastic anemia (AA) was lowest, as compared with that of other diseases (P < 0.05), while PTE in operation group was highest. The comparison of PTE among groups of transfusion frequency revealed also statistical difference (P < 0.01), meanwhile PTE decreased with increasing of transfusion frequency. The comparison of PTE among groups of platelet type (platelet phoresis or platelet concentrate) showed statistical difference (P < 0.01). The comparison of PTE among groups of platelet concentrate of once transfusion amount showed no statistical difference (P > 0.05). It is concluded that the PTE closely relates with disease cause of patients, moreover transfusion frequency also associates with PTE, the more frequency of transfusion, the higher possibility of transfusion refractoriness. The PTE of platelet pheresis is obviously superior to that of platelet concentrate, while PTE of platelet concentrate not significantly relates with once adequate or not.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anemia, Aplastic ; therapy ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Leukemia ; therapy ; Male ; Middle Aged ; Platelet Count ; Platelet Transfusion ; adverse effects ; methods ; Treatment Failure ; Young Adult

OBJECTIVETo evaluate the efficacy and safety of recombinant human thrombopoietin (rhTPO) in treatment for chemotherapy-induced thrombocytopenia in patients with lung cancer.

METHODSFifty-one lung cancer patients with platelet count < 100 x 10(9)/L after chemotherapy were enrolled into this study. They were divided into three groups: mild, moderate and severe thrombocytopenia groups according to the platelet count. rhTPO was subcutaneously administered at a dosage of 300 microg kg(-1) d(-1) until the platelet count >or= 100 x 10(9)/L or absolute value of platelet count >or= 50 x 10(9)/L. Laboratory tests included routine blood count, serum biochemistry, and blood coagulation test.

RESULTSThe duration of the chemotherapy-induced thrombocytopenia was significantly shorter in the mild group than that in the moderate and severe groups (P < 0.01). After administration of rhTPO, the time of declined platelet count beginning to recover was also significantly shorter in the mild group than that in the moderate and severe groups (P < 0.01). There was a statistically significant difference in platelet transfusion needed among the three groups (P < 0.01). However, no significant difference was found among the three groups in the time of rhTPO treatment (P > 0.05) and platelet count improvement (P > 0.05).

CONCLUSIONRecombinant human thrombopoietin can be effectively and safely administered to deal with grade III/IV chemotherapy-induced thrombocytopenia in lung cancer patients with mild adverse effects.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Dizziness ; chemically induced ; Female ; Fever ; chemically induced ; Humans ; Lung Neoplasms ; blood ; drug therapy ; Male ; Middle Aged ; Platelet Count ; Platelet Transfusion ; Recombinant Proteins ; adverse effects ; therapeutic use ; Thrombocytopenia ; chemically induced ; drug therapy ; therapy ; Thrombopoietin ; adverse effects ; therapeutic use

The study was aimed to investigate the value of activated plasma clotting time (APCT) for estimating the efficacy of platelet transfusion therapy. There were twenty patients with hematological diseases, who received transfusion of platelet, involved in the test. APCT was determined before and after transfusion of these patients, then APCT was contrasted with corresponding CCI and PPR. The results showed that 1 hour and 24 hour APCTs were shortened obviously. APCT before transfusion was (103.7 +/- 11.3) seconds, but the 1 hour and 24 hour APCTs were shortened to (60.0 +/- 9.7) seconds and (68.5 +/- 9.8) seconds respectively (P < 0.01). According to the judging criteria of CCI and PPR (CCI and PPR values at 1 and 24 hours after transfusion are < 7500, < 5000 and < 30%, < 20% respectively, the transfusion is invalid), two patients received invalid transfusion. Their 1 and 24 hour CCIs were 7415, 2966 and 6913, 4988 respectively. Their 1 and 24 hour PPRs were 28.0%, 11.2% and 25.2%, 14.1% respectively. One patient's PPR reached the standard of invalid transfusion, but his CCI showed a valid transfusion he received. Two patients' PPR reached the standard of invalid transfusion, but their 1 hour CCI reached the standard of valid transfusion, and their 24 hour CCI reached the standard of invalid transfusion. It is concluded that APCT reflects the variations of quantity and quality of platelet simultaneously, and can evaluate precisely the efficacy of platelet transfusion.
Adolescent ; Adult ; Aged ; Antineoplastic Agents ; adverse effects ; Bleeding Time ; Blood Platelets ; physiology ; Female ; Humans ; Leukemia ; drug therapy ; therapy ; Male ; Middle Aged ; Myelodysplastic Syndromes ; therapy ; Partial Thromboplastin Time ; Platelet Count ; Platelet Transfusion ; adverse effects ; Thrombocytopenia ; chemically induced ; therapy ; Whole Blood Coagulation Time ; methods