Influence Of RBC Transfusion On Lymphocyte Subsets In Patients With Hematologic Malignancies

Objective:To observe changes of lymphocyte subsets of patients with hematologic malignancies before and after transfusion of red blood cells and explore the impact of RBC transfusion on lymphocyte subsets in patients with hematologic malignancies.Methods:The author collected hospitalized patients in Department of Hematology of Second Hospital of Shanxi Medical University from 2013.9 to 2014.9. These patients have been diagnosed with hematologic malignancies by blood route, bone marrow chromosomes,immune typing, fusion genes and other tests. The patients’ Hemoglobin level was less than70g/L(consistent with clinical indications for blood transfusion) and 144 cases need red blood cell transfusions. Among them, male 69 cases, female 75 cases, and a median age of53 years old(12-76).these cases was consisted of acute myeloid leukemia 73 cases(except APL),34 cases of acute lymphoblastic leukemia,myelodysplastic syndrome 16 cases and multiple myeloma 21 example.All patients were at the rest after chemotherapy.These patients were detected lymphocyte subpopulations before and after RBC transfusion within one month to observe the effects of red blood cell transfusion on lymphocyte subsets in patients with hematologic malignancies(Note:No use the drugs of affecting the immune function during detecting the indicators, such as Thymopentin, lentinan,etc.).And 23 cases of benign blood patients were compared to observe the effects of red blood cell transfusions in patients with benign and malignant hematological lymphocyte subsets,and see whether they are different.Results:Comparing lymphocyte subsets of all 144 cases of patients with hematologic malignancies within one month before and after red blood cell transfusions pointed that Th(CD3+CD4+),Ts(CD3+CD8+),the total T(CD3+) was increasing than before,CD19+ was lower than before and the difference was statistically significant(P<0.05); and Th/Ts, NKT were no significantly difference before and after blood cell transfusions(P>0.05).The patients with hematologic malignancies was divided into two groups with 10 days after red blood cell transfusions as a line.85 cases of patients with hematologic malignancies after transfusion of red blood cells within 10 days showed that the total T(CD3+),Th(CD3+CD4+)and Ts(CD3+CD8+)were up,while CD19+ decreased than before,which above were statistically significant(P<0.05);The Th/Ts,NKT cells compared with before red blood transfusion had no significant difference(P>0.05).Lymphocyte subsets of patients with hematologic malignancies on 10 days to 30 days after red blood transfusion comparing with the former of blood cell transfusion showed that Ts(CD3+CD8+)was increased;Th(CD3+)and Th/Ts were decreased,which were statistically significant(P<0.05);while distinctive of the total T cell(CD3+), NKT cells, CD19+ cells compared before transfusion of red blood cells was no significant difference(P>0.05).Lymphocyte subsets is detected before red blood cells transfusion and 1 month after infusion of group of hematologic malignancies and benign blood disease group was analysis and compared,which showed that Ts(CD3+CD8+) cell before red blood cell transfusions between benign and malignant hematological groups has statistically significant(P<0.05), and hematologic malignant group was lower than the benign;CD19+ cells expression of between hematologic malignancies and the benign group were statistically significant(P<0.05),which of benign group were higher than malignant one before and after transfusion of red blood cells; and the difference of Th(CD3+CD4+), total T cells(CD3+),Th/Ts,NKT cells of benign and hematologic malignancies groups before and after transfusion of red blood cells and Ts(CD3+CD8+) after infusion were no significant(P>0.05).Conclusions:Lymphocyte subset was affected by Red blood cell transfusion for patients with hematologic malignancies.Transfusion of red blood cells can activate the immune response,in part the enhanced immune function cells will rise, and the inhibition of cell will be increased. Over time longer, inhibited cell was dominant position, but immune function will be inhibited. Changes and rules in lymphocyte subsets after red blood cell transfusion for patients with hematologic malignancies were clear,which can help us understand the impact of erythrocyte transfusion on immune function in patients with malignant blood,guide clinical transfusion patients with hematologic malignancies,and reduce adverse reactions of hematologic malignancies during transfusion therapy.