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肿瘤患者血小板输注:更新

英文原题:Platelet Transfusion for Patients with Cancer: An Update.

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Platelet Transfusion for Patients with Cancer: An Update.

PubMed 2025/06/12(内容时间) Transfus Med Hemother Q3 · IF 2.1(JCR 2025)

分数与星级只用于站内排序 —— 不代表疗效、安全性或个人适用性。

研究概要

尽管血小板输注在减轻免疫治疗和 CAR-T 接受者的出血风险方面仍然不可或缺,但患者反应的异质性凸显了需要前瞻性试验来评估输注实践对止血和免疫学结局的影响。

中文摘要

背景:血小板输注对于预防和治疗肿瘤患者出血至关重要,可显著改善生活质量和生存。然而,血小板制品供应常受全球短缺和物流限制,资源有限地区尤为如此。综述概要:维持血小板制品质量需要严格筛查献血者、采用病原体灭活技术并优化储存条件,以保持止血功能并减少不良反应。常见输血并发症(如同种免疫、非溶血性反应和循环超负荷)凸显了实时监测和个体化输血方案的重要性。新型血小板生成素受体激动剂,如 romiplostim 和 eltrombopag,在减少输血依赖方面显示获益,值得在癌症相关血小板减少症中进一步研究。本综述总结血小板输注的研究进展和临床指南,包括血小板制备方法、输注剂量、病原体灭活、白细胞去除、癌症相关血小板减少症类型及血小板输注策略,并讨论未来研究方向与展望。要点:血小板输注仍是降低免疫治疗和 CAR-T 患者出血风险不可或缺的措施,但患者反应存在异质性,凸显需开展前瞻性试验,评估输注实践对止血和免疫结局的影响。

展开英文摘要原文

BACKGROUND: Platelet transfusion is essential for preventing and treating hemorrhage in oncology patients and can markedly improve quality of life and survival. However, access to platelet concentrates is often limited by global shortages and logistical constraints, especially in low-resource settings. SUMMARY: Maintaining product quality requires stringent donor screening, pathogen-reduction technologies, and optimized storage conditions to preserve hemostatic function and reduce adverse reactions. Common transfusion-related complications (e.g., alloimmunization, non-hemolytic reactions, and circulatory overload) underscore the importance of real-time monitoring and individualized transfusion protocols. Emerging thrombopoietin receptor agonists, such as romiplostim and eltrombopag, exhibited benefit in reducing transfusion dependency and merit further study in cancer-associated thrombocytopenia. This review aims to summarize the research advances and clinical guidelines on platelet transfusion, including platelet production methods, transfusion dosage, pathogen inactivation, leucocyte depletion, types of cancer-related thrombocytopenias, and platelet transfusion strategies and to discuss future research directions and perspectives. KEY MESSAGES: While platelet transfusions remain indispensable for mitigating bleeding risk in immunotherapy and CAR-T recipients, the heterogeneity of patient responses underscores the need for prospective trials to evaluate the impact of transfusion practices on both hemostatic and immunologic outcomes.

论文信息

作者
Wang Y、Zhang L、Ma N、Wang Y
第一作者单位
Department of Blood Transfusion, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Peking University Cancer Hospital Yunnan, Kunming, China.China
通讯作者单位
Department of Cadre Healthcare, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Peking University Cancer Hospital Yunnan, Kunming, China.China
文献类型
综述
期刊
Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie2025 Dec
原文标识
PubMed 40808881 · DOI 10.1159/000546566