血小板频繁捐献者面临淋巴细胞减少症的风险
在美国，绝大多数的血小板制品是通过单采设备采集的。个人可以在12个月的时间内捐献24次单采血小板。在血小板减少性疾病期间，通常会进行白细胞降低以减少输血反应，但血小板献血者中淋巴细胞耗竭的长期影响尚不清楚。因此，一家医院血小板捐赠中心的研究人员进行了一项横断面研究，检测了单采血小板捐献者的免疫细胞。根据过去365天内血小板减退症的次数，将捐赠者分为三组：1或2次(N=20)，3至19次(N=20)，或20至24次(N=20)。各组中0.019%(0/20)、10%(2/20)、30%(6/20)的供者CD4+T淋巴细胞计数较低(P=0.019)。CD8+T-淋巴细胞计数低于正常者分别为0.001%(0/20)、20%(4/20)和55%(11/20)(P<0 .001)。在白细胞还原系统室内发现大量淋巴细胞(15%~20%)，这可能是单采血小板献血者淋巴细胞耗竭的原因之一。t细胞受体的多样性在所有人群中都是相似的，而且所有的捐献者都报告总体上健康状况良好。频繁血小板献血者淋巴细胞减少的长期后果和持续时间需要进一步研究。
原文：In the US, the vast majority of platelets are collected via apheresis. Individuals may donate apheresis-derived platelets up to 24 times in a 12 month period. During plateletpheresis, leukoreduction is often performed to reduce transfusion reactions, but the long-term effect of lymphocyte depletion among platelet donors is unclear. Thus, researchers at one hospital-based platelet donation center performed a cross-sectional study examining immune cells in apheresis platelet donors. Donors were categorized into three groups based on the number of plateletpheresis sessions within the last 365 days: 1 or 2 sessions (N=20), 3 to 19 sessions (N=20), or 20 to 24 sessions (N=20). CD4+ T-lymphocyte counts were low in 0% (0/20), 10% (2/20), and 30% (6/20) of donors in each respective group (P=0.019). CD8+ T-lymphocyte counts were also below normal in 0% (0/20), 20% (4/20), and 55% (11/20) of donors in each group, respectively (P<0 .001). large numbers of lymphocytes (15-20%) were found in the leukoreduction system chamber, which may contribute to lymphocyte depletion in apheresis platelet donors. t-cell receptor diversity was similar across all groups, and all donors reported generally good health. the long-term consequences and duration of lymphopenia in frequent platelet donors needs further investigation.
参考文献:
Gansner JM, Rahmani M, Jonsson AH, Fortin BM, et al. Plateletphersis-associated lymphopenia in frequent platelet donors. Blood 2019; 133(6): 605-614.
