Analysis of factors influencing platelet transfusion in children with high-risk stage Ⅳ neuroblastoma undergoing autologous hematopoietic stem cell transplantation
10.13303/j.cjbt.issn.1004-549x.2025.07.005
- VernacularTitle:Ⅳ期高危神经母细胞瘤患儿自体造血干细胞移植血小板输注的影响因素分析
- Author:
Xiaoyan FU
1
;
Zida ZHEN
1
;
Lijuan QIU
1
;
Huimin ZHANG
1
;
Mengjian WANG
1
;
Shuaihang ZHANG
1
;
Shuxuan MA
1
Author Information
1. Department of Blood Transfusion, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
- Publication Type:Journal Article
- Keywords:
neuroblastoma;
autologous hematopoietic stem cell transplantation (ASCT);
platelet transfusion;
conditioning regimen
- From:
Chinese Journal of Blood Transfusion
2025;38(7):896-901
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To evaluate the platelet transfusion requirements in children with high-risk stage Ⅳ neuroblastoma undergoing autologous hematopoietic stem cell transplantation (ASCT), and to identify risk factors for increased transfusion needs and prolonged time to platelet transfusion independence. Methods: This single-center retrospective clinical study included 96 children with high-risk stage Ⅳ neuroblastoma who underwent ASCT from January 2019 to May 2024 in our hospital. Relevant clinical data were collected and analyzed, including age, gender, body surface area, platelet count (PLT) on stem cell infusion day (day 0), conditioning regimen, CD34
stem cell dose, platelet transfusion requirements during transplantation, and time to platelet transfusion independence post-transplant. Results: All 96 (100%) children received transfusion after ASCT. From day 0 to transfusion independence, the median number of platelet transfusion was 3 (2, 4.50), and the median volume of platelet transfused was 3 (2, 4.25) units. Platelet transfusion was required in almost all children in pseudo-healing stage (day 4 to day 6) and polar stage (day 7 to day 14), with transfusion rates as high as 83.33%(n=80) and 100%(n=96), respectively. The median time to platelet transfusion independence post-transplant was 13(11,17) days. Multivariate analysis showed that PLT<100×10
/L on day 0, platelet transfusion within one week before ASCT, the use of “busulfan+ melphalan” conditioning regimen, and CD34
stem cell dose<4.0×10
/kg were associated with significantly increased platelet requirements and numbers of transfusion (P<0.05). PLT<100×10
/L on day 0, platelet transfusion within one week before ASCT, and CD34
stem cell dose<4.0×10
/kg were associated with significantly delayed platelet transfusion independence (P<0.05). Age, sex, and blood type showed no statistically significant association (P>0.05) with post-transplant platelet transfusion requirements or time to transfusion independence in neuroblastoma patients. Conclusion: This study provided quantitative data for platelet transfusion after ASCT in children with high-risk stage Ⅳ neuroblastoma, and identified PLT<100×10
/L on day 0, platelet transfusion within one week before ASCT, CD34
stem cell dose<4.0×10
/kg were risk factors for increased platelet transfusions and delayed transfusion independence. Furthermore, the use of the BuMel (busulfan-melphalan) conditioning regimen was also found to contribute to increased transfusion requirements.
