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Platelet transfusion refractoriness in patients with acute myeloid leukemia treated by intensive chemotherapy.

Abstract：

:Platelet transfusion refractoriness (PTR) is a major adverse event in the management of acute myeloid leukemia (AML). In a series of 897 adult patients with AML receiving intensive chemotherapy, we identified 41 patients (4.8%) with PTR. PTR was more frequently observed in parous women, patients with extra-medullary disease, a low white blood cell count, an infection, or hemophagocytic syndrome. Among the 31 patients with anti-human leucocyte antigen (HLA) antibodies, an HLA-matched donor was identified for 18 patients (58.1%). Median time between diagnosis of PTR and the first HLA-matched transfusion was 12.5days. HLA-matched transfusions induced a significant increment in platelet counts in 37% of cases. Thrombopoietin receptor agonists were given to 10 patients but did not shorten the duration of thrombocytopenia, reduce severe bleeding, or early death. Grade 3-4 bleeding events during induction, early death caused by bleeding, and death caused by bleeding at any time were significantly greater in patients that had platelet transfusion refractoriness (22% vs. 4.1%, P<0.0001; 12.2% vs. 1.4%, P=0.0006; and 24.4% vs. 5.3%, P<0.0001; respectively). PTR during chemotherapy for AML significantly increased the risk of early and late deaths caused by a severe bleeding event. Improved understanding of platelet destruction is needed to design mechanism-based therapeutic strategies.

journal_name

Leuk Res

journal_title

Leukemia research

authors

Comont T,Tavitian S,Bardiaux L,Fort M,Debiol B,Morère D,Bérard E,Delabesse E,Luquet I,Martinez S,Huguet F,Récher C,Bertoli S

doi

10.1016/j.leukres.2017.08.015

subject

Has Abstract

pub_date

2017-10-01 00:00:00

pages

62-67

eissn

0145-2126

issn

1873-5835

pii

S0145-2126(17)30496-4

journal_volume

61

pub_type

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