Pre-transplant thrombocytopenia predicts engraftment time and blood products requirement in allogeneic hematopoietic stem cell transplantation patients |
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| Institution: | 1. Department of Hematology, Tarbiat Modares University, Tehran, Iran;2. Hematopoietic Stem Cell Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran;3. Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran;1. Animal and Veterinary Research Centre (CECAV), University of Trás-os-Montes e Alto Douro (UTAD), Vila Real, Portugal;2. Blood and Transplantation Centre of Lisboa, Portuguese Institute for Blood and Transplantation (IPST), Lisboa, Portugal;3. Blood and Transplantation Centre of Porto, Portuguese Institute for Blood and Transplantation (IPST), Porto, Portugal;4. Department of Veterinary Sciences, School of Agrarian and Veterinary Sciences, UTAD, Vila Real, Portugal;1. Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain;2. Dept. of Medicine, University of Oviedo, Spain;3. International Consultancy in Strategic Advices on Safety Improvements of Blood-Derived Bioproducts and Suppliers Quality Audit / Inspection, London, England, UK;1. Department of Haematology, Transfusion Medicine and Biotechnologies, Ospedale Civile, Pescara, Italy;2. Immunohaematology and Transfusion Medicine, “Umberto Parini” Hospital, Aosta, Italy;3. Transfusion Medicine Department, Azienda Sanitaria Universitaria \"Friuli Centrale\", Udine, Italy;4. Blood Transfusion Service, University Hospital of Padua, Padua, Italy;5. Transfusion Medicine Department, Azienda Sanitaria Universitaria “Giuliano Isontina”, Trieste, Italy;6. Transfusional Medicine Unit, University-Hospital Policlinico, Bari, Italy;1. Department of Hematology, Hacettepe University Faculty of Medicine, Ankara, Turkey;2. Department of Medical Biology, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey |
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| Abstract: | IntroductionThrombocytopenia is a common consequence of leukemia that affects the outcome of hematopoietic stem cell transplantation (HSCT). The stromal damage of bone marrow following pre-HSCT conditioning regimens can delay the hematopoietic engraftment and increased blood product transfusions. We tried to define threshold based on pre-transplant platelet count as a biomarker to predict engraftment time and blood product requirements in allogeneic HSCT patients.MethodsThis retrospective study was performed on 194 patients who received allogeneic HSCT. The median for platelet (PLT) count of patients at the admission day was considered as a cut off value. The association of platelet count with white blood cell (WBC) and PLT engraftment time and also the requirement of packed red blood cell or PLT transfusions as outcomes of interest were investigated.Results164 patients (84.5 %) had successful WBC engraftment, and PLT engraftment was seen in 155 patients (79.9 %) in 30 and 50 days after HSCT, respectively. The patients with PLT count higher than 154,000/μL had better PLT engraftment (P = 0.060), and WBC engraftment (P = 0.014) than those with PLT count lower than this cut off. The pre-transplant PLT count had negative relations with SD platelet requests after HSCT (P = 0.008).ConclusionThe thrombocytopenia before HSCT might delay the platelet and WBC engraftment time, which should be taken into account before transplantation. Since the blood product transfusion is one of the factors associated with engraftment, the pre-transplant platelet count can be used as a predictive biomarker to manage the blood product requirement during the HSCT until engraftment occurs. |
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| Keywords: | Allo-HSCT Blood products requirement Engraftment Thrombocytopenia |
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