Risk factors of platelet transfusion refractoriness in patients undergoing hematopoietic stem cell transplantation and its influence on prognosis
10.3969/j.issn.1009-0754.2025.08.018
- VernacularTitle:造血干细胞移植患者血小板输注无效的危险因素分析及其对患者预后的影响
- Author:
Muhan WANG
1
;
Wenlong LI
;
Ziyang FENG
;
Heshan TANG
;
Zhanshan ZHA
Author Information
1. 200433 上海,海军军医大学第一附属医院
- Keywords:
Hematopoietic stem cell transplantation;
Platelet transfusion refractoriness;
Risk factors;
Prognosis
- From:
Journal of Navy Medicine
2025;46(8):839-843
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the risk factors of platelet transfusion refractoriness(PTR)in patients undergoing hematopoietic stem cell transplantation(HSCT)and its influence on the prognosis of the patients.Methods A total of 104 patients who underwent HSCT in The First Affiliated Hospital of Naval Medical University from February 2018 to February 2021 were enrolled and assigned to PTR group(n=36)or non-PTR group(n=68).The clinical data of the two groups were collected to investigate PTR-related factors in HSCT patients.The patients were followed up for 3 years after transplantation,and the survival and the influence of PTR on the prognosis were analyzed.Results The proportions of no platelet antibody matching,blood transfusion≥6 times,high fever,splenomegaly,infection,and skin and mucous membrane bleeding in the PTR group were significantly higher than those in the non-PTR group(P<0.05).The platelet count on admission in the PTR group was significantly lower than that in the non-PTR group(P<0.05).No platelet antibody matching(β=-0.837),blood transfusion≥6 times(β=0.905),high fever(β=0.516),splenomegaly(β=0.773),and infection(β=0.695)were independent risk factors of PTR in HSCT patients(P<0.05).The rates of overall survival(OS)and recurrence-free survival(RFS)in the PTR group were significantly lower than those in the non-PTR group(P<0.05).After multivariate adjustment,PTR was associated with poorer OS(HR=2.764,95%CI:1.267-6.643)and RFS(HR=2.139,95%CI:1.046-5.114).Conclusion The occurrence of PTR in HSCT patients is related to platelet antibody matching,blood transfusion frequency,high fever,splenomegaly,and infection.PTR can affect the prognosis of HSCT patients,and shorten the OS and RFS.
