The clinical characteristics of patients with acute leukemia or stem cell transplantation exhibiting immune based platelet refractoriness |
| |
| Affiliation: | 1. Department of Hematology, The First Affiliated Hospital, Sun Yat-sen University, 58 zhongshan er ave, Guangzhou, China;2. Department of Blood Transfusion, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China;3. Department of Radiology Intervention, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China;1. International Consultancy in Strategic Advice on Safety Improvements of Blood-Derived Bioproducts and Suppliers Quality Audit / Inspection, London, UK;2. Romagna Transplant Network, Hematology Unit, Ravenna-I, Italy;1. Department of Hematology and Bone Marrow Transplantation Center, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey;2. Department of Hematology, Sakarya University Medical Faculty, Sakarya, Turkey;1. Military Blood Bank, Ministry of Defense, Utrecht, the Netherlands;2. Department of Surgery, Alrijne Medical Centre, Leiderdorp, the Netherlands;3. Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, the Netherlands;4. Ministry of Defense, Department of Surgery, Leiden University Medical Centre, Leiden, the Netherlands;1. Center of Clinical Laboratory, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, PR China;2. Shenzhen Academy of Inspection and Quarantine, Shenzhen, 518010, China;3. Central Laboratory of Health Quarantine, Shenzhen International Travel Health Care Center, Shenzhen Entry-exit Inspection and Quarantine Bureau, Shenzhen, 518033, PR China;4. Department of Clinical Laboratory, Guangzhou Eighth People''s Hospital, Guangzhou Medical University, Guangzhou, 510060, PR China;5. Department of Biomedical Engineering, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region;6. Biochemistry Programme, School of Life Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region;7. The Third People''s Hospital in Nanhai District Fuoshan City, Foshan, 528244, PR China |
| |
| Abstract: | BackgroundTo investigate the related factors influencing immune platelet transfusion refractoriness (PTR) in acute leukemia (AL) from induction to consolidation and compare management for immune PTR, so as to improve the Platelet increment in AL.MethodsThe primary analysis included 890 patients with AL, 225 of whom were the immune PTR (25 %).They are patients in our center from induction to consolidation or transplantation in the past 10 years. Flow cytometry, karyotype characteristics and other basic information were compared between the immune PTR vs control (no-PTR) groups. We analyzed the treatment outcomes of immune PTR including matched platelets, intravenous immunoglobulin (IVIG), increasing apheresis platelet does. Results: Immune PTR is more likely to occur in patients with poor prognosis in acute lymphoblastic leukemia (ALL) (P = 0.01).There is a relation between NPM1 mutation and occurrence of immune PTR (P = 0.029).The incidence of PTR at 35-59Y was higher than that at <35Y(OR = 0.68, 95 % CI = 0.48-0.96) and ≥60Y(OR = 0.49,95 % CI = 0.28-0.83), and the difference was statistically significant(P = 0.03, P = 0.01).The Platelet increment with 1 unit (u) was 47.12 %, 2 u increased to 71.14 %, and the matched 2 u (75.11 %) had the best effect. IVIG improved the Platelet increment, but there was no difference between 0.4 g/kg IVIG and 1 g/kg IVIG. Immune PTR is more likely to occur in the ages of 35–60 years.ConclusionThere are specific AL patient characteristics which predispose to the phenomenon of immune based PTR. Meanwhile, increasing the IVIG dose could not improve Platelet increment obviously. |
| |
| Keywords: | Platelet transfusion refractoriness Acute leukemia Immune |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
