Pediatric Hematology/Oncology and ImmunopathologyPediatric Hematology/Oncology and ImmunopathologyВопросы гематологии/онкологии и иммунопатологии в педиатрии1726-17082414-9314Fund Doctors, Innovations, Science for Children21210.24287/1726-1708-2018-17-4-43-50ORIGINAL ARTICLESОРИГИНАЛЬНЫЕ СТАТЬИResults of clinical application of pathogen-reduced red blood cell suspension in children with oncological and hematological diseasesРезультаты клинического применения патоген-редуцированной эритроцитной взвеси у детей с онкологическими и гематологическими заболеваниямиhttps://orcid.org/0000-0002-9881-1041KumukovaI. B.КумуковаИ. Б.
Russian Federation

transfusiologist.

117997, Moscow, Samory Mashela st., 1. 

врач-трансфузиолог.

 117997, Москва, ГСП-7, ул. Саморы Машела, 1. 

irina_kumukova@mail.ruhttps://orcid.org/0000-0002-0231-1617TrakhtmanP. I.ТрахтманП. Е.
Russian Federation
https://orcid.org/0000-0002-1219-8654StarostinN. N.СтаростинН. Н.
Russian Federation
https://orcid.org/0000-0002-8392-6209KadaevaL. J.КадаеваЛ. Ж.
Russian Federation
https://orcid.org/0000-0002-7576-4836ChaykinaO. A.ЧайкинаО. А.
Russian Federation
Dmitriy Rogachev National Medical Research Center of Pediatric Hematology, Oncology, Immunology Ministry of Healthcare of Russian Federation.ФГБУ «Национальный медицинский исследовательский центр детской гематологии, онкологии и иммунологии им. Дмитрия Рогачева» Минздрава России.1301201917443501201201912012019Copyright ©; 2019, «D. Rogachev NMRCPHOI»Copyright ©; 2019, ФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева» Минздрава России2019«D. Rogachev NMRCPHOI»ФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева» Минздрава Россииhttps://creativecommons.org/licenses/by/4.0https://hemoncim.com/jour/article/view/212

The problem of blood-borne infections remains relevant in transfusion medicine. Pathogen reduction technologies (PRT) provide a preventive approach to a wide range of transfusion-transmitted infectious diseases. To date, PRT widely used for a number of blood components, however, the use of these technologies for the treatment of erythrocyte-containing components has not been studied. Objective: to conduct a comparative analysis of the clinical efficacy of transfusions of pathogen-reduced and gamma-irradiated erythrocyte suspension in pediatric patients with various oncological and hematological diseases. Seventy transfusions of red blood cell suspensions (RBC-S) (35 transfusions of pathogen-reduced RBC-S and 35 transfusions of gammairradiated RBC-S) in pediatric patients with oncological and hematological diseases were analized. Clinical efficacy parameters such as the hemoglobin and the hematocrit increment after transfusion, the interval between transfusions, the frequency and severity of transfusion reactions were estimated. We also evaluated the correlation between the hemoglobin and the hematocrit increment with age, patient’s body weight, the hemoglobin concentration and patient's hematocrit before transfusion, the volume of transfusion, the hemoglobin dose and the adjusted hemoglobin dose received for transfusion. We found that the clinical efficacy and safety of RBC-Ss of the compared groups did not differ: the hematocrit and the hemoglobin increment, the frequency and severity of transfusion reactions, and the interval between transfusions were comparable between groups. There was no evidence of immune elimination and allo-sensibilization caused by pathogen-reduced RBC-S. In the group of patients receiving pathogen-reduced RBC-S, a correlation was found between the increase in the hemoglobin and hematocrit values with some of the EV indices. According to our data, the spectrum of efficiency and safety indicators of pathogen-reduced RBC-S is no worse than that of gamma-irradiated RBC-S, provided that RBC-S is used for 14 days of storage.

Проблема гемотрансмиссивных инфекций сохраняет актуальность в практической трансфу- зиологии. Технологии редукции патогенов (ТРП) обеспечивают превентивный подход в отношении широкого спектра трансфузионно-опасных инфекций. ТРП нашли широкое применение при клиническом использовании ряда компонентов крови, однако возможности использования данных технологий для обработки эритроцитсодержащих компонентов не изучены. Целью работы был сравнительный анализ клинической эффективности трансфузий патоген-редуцированной и гамма-облученной эритроцитной взвеси у пациентов детского возраста с различными онкологическими и гематологическими заболеваниями. Проведен анализ 70 трансфузий эритроцитных взвесей (ЭВ) в двух группах пациентов детского возраста с онкологическими и гематологическими заболеваниями (35 трансфузий патоген-редуцированной ЭВ и 35 трансфузий гамма-облученной ЭВ). Исследованы параметры клинической эффективности: прирост гемоглобина и гематокрита после трансфузии, интервал между трансфузиями, частота и тяжесть посттрансфузионных реакций. Проведена оценка наличия корреляции между приростом гемоглобина и гематокрита с возрастом, массой тела пациента, концентрацией гемоглобина и гематокрита пациента до трансфузии, объемом трансфузии, дозой гемоглобина и скорректированной дозой гемоглобина, полученной за трансфузию. Исследование показало клиническую эффективность и безопасность сравниваемых ЭВ. Прирост гемоглобина, гематокрита, частота и тяжесть посттрансфузионных реакций, а также интервал между трансфузиями не отличались в двух группах пациентов. Использование патоген-редуцированной ЭВ не приводило к активации иммунного ответа. У пациентов, получавших патоген-редуцированную ЭВ, была обнаружена корреляционная связь между приростом гемоглобина и гематокрита с дозой и скорректированной дозой гемоглобина, полученной за трансфузию. Эффективность и безопасность патоген-редуцированной ЭВ представляются не хуже, чем гамма-облученной ЭВ, при условии использования ЭВ в течение 14 дней хранения.

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