多項目自動血球分析装置XE-2100を用いた幼若血小板比率測定の臨床的有用性 : 化学療法および造血幹細胞移植後の血小板回復時期の予測マーカーとして  [in Japanese] IMMATURE PLATELET FRACTION MEASURED USING THE AUTOMATED HEMATOLOGY ANALYZER XE-2100 : A POSSIBLE PREDICTIVE MARKER FOR PLATELET RECOVERY AFTER CHEMOTHERAPY AND HEMATOPOIETIC STEM CELL TRANSPLANTATION  [in Japanese]

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Abstract

[背景·目的]化学療法後の血小板回復時期を予測することは,適切な血小板輸血を実施する際に重要である.我々は,多項目自動血球分析装置XE-2100の網赤血球測定チャンネルを用いて測定した幼若血小板(immature platelet fraction,IPF)の臨床的有用性について検討した.<br> [対象·方法]XE-2100を用いて,健常人130名および患者100名のIPF%(血小板数に対するIPFの比率)を測定した.また,延35コースの化学療法および造血幹細胞移植を施行した19名の悪性腫瘍患者を対象に経時的にIPF%を測定し,後方視的に解析した.<br> [結果]健常人のIPF%は,2.8±1.4%であった.また,IPF%と血小板数との間には,負の相関性(r=0.319)を認めた.化学療法および造血幹細胞移植症例では,血小板数が30×10<sup>9</sup>/<i>l</i>以上に回復する1∼11日前にIPF%の一過性の上昇(IPF%ピーク値)が認められた.IPF%ピーク値が10%以上の化学療法例では,10%未満の症例に比べ有意に血小板回復が早期より認められた(3日対5日,P=0.0164).また,IPF%ピーク値が10%以上であった自家移植例では,10%未満の同種移植例に比べて血小板回復が早期より認められた(2日対4∼11日).<br> [結論]IPF%は,化学療法および造血幹細胞移植後の血小板回復時期を予測し,適正な血小板輸血を実施する際に有用なマーカーとなる可能性が示唆された.<br>

<b>Background and Purpose:</b> The ability to predict platelet recovery after chemotherapy allows for a more reasonable approach to platelet transfusion. We assessed the clinical utility of monitoring the percentage of immature platelet fraction (IPF%) using the XE-2100 automated hematology analyzer to predict platelet recovery.<br> <b>Patients and Methods:</b> The IPF% of 130 healthy volunteers and 100 patients was measured using the XE-2100. Further, IPF% was serially monitored in 19 cancer patients who received 35 courses of chemotherapy and hematopoietic stem cell transplantation (HSCT), and data were then retrospectively analyzed.<br> <b>Results:</b> The IPF% in 130 healthy volunteers was 2.8±1.4% and inversely correlated with platelet count (r=0.319). In cancer patients undergoing chemotherapy and HSCT, a transient increase in IPF% (IPF% peak) was observed prior to recovery of the platelet count to more than 30×10<sup>9</sup>/<i>l</i> within 1 to 11 days. In cases undergoing chemotherapy with more than 10% of the IPF% peak value, platelet recovery (>30×10<sup>9</sup>/<i>l</i>) occurred significantly earlier than in those with less than 10% of the IPF% peak value (3 and 5 days, respectively; p=0.0164). In one case undergoing autologous HSCT with more than 10% of the IPF% peak value, platelet recovery occurred earlier than in cases undergoing allogeneic HSCT with less than 10% of the IPF% peak value (2 days and 4-11 days, respectively). <br> <b>Conclusion:</b> Findings in the present study suggest that IPF% is a useful parameter for predicting platelet recovery after chemotherapy and HSCT, as well as has the potential to facilitate optimal platelet transfusion.<br>

Journal

  • Japanese Journal of Transfusion and Cell Therapy

    Japanese Journal of Transfusion and Cell Therapy 55(6), 691-697, 2009-12-25

    The Japan Society of Transfusion Medicine and Cell Therapy

References:  20

Codes

  • NII Article ID (NAID)
    10026334298
  • NII NACSIS-CAT ID (NCID)
    AA12159645
  • Text Lang
    JPN
  • Article Type
    ART
  • ISSN
    18813011
  • Data Source
    CJP  J-STAGE 
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