Abstract:
OBJECTIVE To explore the efficacies of leukocyte-depleted blood transfusion and common component blood transfusion therapy on immunity, RBC-C3b receptor rosette (RBC-C3bR), blood transfusion reactions and incidence rate of infection in patients with acute leukemia (AL).
METHODS Ninety-two AL patients who received treatment in Guizhou Provincial People′s Hospital from Jan. 2022 to Dec. 2023 were selected and were divided into the study and the control group by the simple randomization method with 46 cases in each group. The control group adopted common blood components transfusion therapy, while the study group was treated with leukocyte-depleted blood transfusion therapy. The immune function, red blood cell (RBC)immune function RBC-C3bR, RBC-immune complex rosette (RBC-ICR), adverse reactions, serum inflammatory factors interleukin-4 (IL-4), interleukin-10 (IL-10), interleukin-2 (IL-2), interferon-γ (IFN-γ) and incidence rate of infection were compared between the two groups before and after 1 week of blood transfusion.
RESULTS Compared with pretransfusion, posttransfusion CD3+, CD4+ and CD4+/CD8+ levels in the two groups significantly increased (P < 0.05); while CD8+ significantly decreased (P < 0.05). The differences of CD3+, CD4+ and CD4+/CD8+ before and after transfusion were statistically different between the two groups (-10.92±3.70)% vs. (-6.14±3.71)%, (-6.41±2.83)% vs. (-4.48±2.21)%, -0.33±0.04 vs.-0.21±0.04, respectively, P < 0.05, while CD8+ showed no difference. Posttransfusion RBC-C3bR in both groups significantly raised and RBC-ICR was on the contrary (P < 0.05), and the differences before and after transfusion between the two groups were statistically different (-4.68±2.81)% vs. (-2.49±2.67)%, (3.55±2.13)% vs. (2.03±2.43)%, respectively P < 0.05. The total incidence rate of adverse reactions in the study group was 8.70%, lower than 23.91% in the control group (P < 0.05). The posttransfusion levels of IL-4, IL-10, IL-2 and IFN-γ in the two groups elevated significantly compared with pretransfusion(P < 0.05), and the differences of the above levels before and after blood transfusion were statistically different between the two groups (P < 0.05). The total incidence rate of infection during the chemotherapy in the study group with 17.39%, lower than 36.96% in the control group (P < 0.05).
CONCLUSIONS Leukocyte-depleting blood transfusion therapy can significantly reduce the adverse reactions of blood transfusion in patients with AL chemotherapy, ameliorate the suppression of immunity and inflammation and raise the safety of blood transfusion. It is beneficial for the infection control for AL patients.