Terapevticheskii arkhivTerapevticheskii arkhiv0040-36602309-5342LLC Obyedinennaya Redaktsiya30756The survival and sequestration of transfused donor platelets in cytostatic cytopeniasMigunovaEkaterina Valentinovnanuclear@blood.ruSakhibovYashin Daminovichnuclear@blood.ruRyzhkoVyacheslav Vladimirovich-SorkinaOl'ga Markovna-SagdievaNadzhiya Shavkatovnagamma@blood.ruGemdzhyanEduard Georgieviched366@mail.ruMigunovaE VHematology Research Center, Russian Academy of Medical Sciences-SakhibovYa DHematology Research Center, Russian Academy of Medical Sciences-RyzhkoV VHematology Research Center, Russian Academy of Medical Sciences-SorkinaO MHematology Research Center, Russian Academy of Medical Sciences-SagdiyevaN ShHematology Research Center, Russian Academy of Medical Sciences-GemdzhyanE GHematology Research Center, Russian Academy of Medical Sciences-Hematology Research Center, Russian Academy of Medical Sciences151220108212515609042020Copyright © 2010, Consilium Medicum2010Aim. To study the survival and sequestration of transfused donor platelets labeled with 51Cr in patients with acute leukemia (AL).
Subjects and methods. Seven donor volunteers and 39 patients with different forms with AL at various stages of polychemotherapy (PCT) were examined. Cytostatic therapy was accompanied by 51Cr-labeled platelet concentrate (PC) transfusions. The patients were on appropriate high-dose (HD) PCT.
Results. The duration of donor platelet circulation was 8-10 days in healthy individuals. No platelet hypersequestration was recorded in both the spleen and the liver. Donor platelet survival was shorter in all patients with in a state of cytostatic cytopenia. There was an inverse correlation between the degree of circulation shortening and some clinical and hematological parameters (the bone marrow level of blastemia and blastosis, the XIIa-dependent fibrinolysis parameters). Four variants of radioactivity trends above the spleen and liver were identified. The findings suggest that there is platelet hypersequestration in the spleen, liver, and both organs. In some patients, the above both organs are uninvolved in the hypersequestration processes and the possible mechanism for increased consumption of transfused donor platelets, which is associated with recovery of the HD PCT-damaged vascular endothelium is considered.
Conclusion. Shortening of transfused donor platelet circulation was found in relation to the level of blastosis. The described procedure may be used as one of the additional methods for evaluating the efficacy of donor PC transfusion and for specifying the pathogenesis of thrombocytopenias in AL patients on programmed HD PCT. A procedure is proposed to time the circulation of 51Cr-labeled platelets, by assessing deposit phenomena and estimating the level of their sequestration in the spleen and liver for the prediction of the efficiency of TC transfusions.acute leukemiaplatelet concentrateradiotracerострый лейкозтромбоцитный концентратрадиоактивная метка[Воробьев А. И., Бриллиант М. Д., Савченко В. Г. Руководство по гематологии. М.; 2002; т. 1: 201-204.][Савченко В. Г., Паровичникова Е. Н. Лечение острых лейкозов (Клинические исследования). М.: МЕДпресс-информ; 2004. 224-232.][Сведенцов Е. П. Переливание концентрата тромбоцитов. В кн.: Руководство по трансфузионной медицине. Киров; 1999. 412-418.][Сахибов Я. Д. Клиническая эффективность и приживляемость донорских тромбоцитов. В кн.: Сведенцов Е. П. и др. Заготовка и консервирование тромбоцитов для клинического применения. Ташкент: 1996. 76-85.][Сахибов Я. Д., Сагдиева Н. Ш., Новокщенова Л. В. К вопросу о выживаемости тромбоцитов при некоторых заболеваниях крови. Тер. арх. 1992; 12: 48-51.][Мигунова Е. В., Сахибов Я. Д., Сагдиева Н. Ш. и др. Радионуклидное 51Cr определение выживаемости и секвестрации облученных донорских тромбоцитов у больных острыми лейкозами. Мед. радиол. 2009; 1, 54(2): 69-72.][Snyder E. L., Baril L., Corda T. Protocol for 51Cr and 111In radiolabeling of frech blood platelets in vitro. Transfusion 2004; 44: 76A.][Tsukada T., Tango T. On the methods calculating mean survival time in 51Cr-platelet survival study. Am. J. Hematol. 1980; 8: 281.][Holme S., Heaton A., Roodt J. Concurrent label method with 111In- and 61Cr allows accurate evaluation of platelet viability of stored platelet concentrates. Br. J. Haematol. 1993; 84: 717- 723.][Dumontm L. J. Analysis and reporting of platelet kinetic stadies. Transfusion 2006; 46S: 67-73.][De Vos F. U., Willemse P. H.., De Vries E. G. Endothelial cell effects of cytotoxics: balans between desired and unwanted effects. Cancer Treat. Rev. 2004; 30: 495-513.][Doll D. C., Yarbro J. W. Vascular toxicity associated with chemotherapy agents. Semin. Oncol. 1992; 19(5): 580-596.][Баркаган З. С. Нарушения гемостаза при онкогематологических заболеваниях. В кн.: Воробьев А. И. Руководство по гематологии. М.; 2005; т. 3: 129-130.]