Incidence and clinical significance of platelet transfusion refractoriness after allogeneic hematopoietic stem cell transplantation in patients with chronic myelomonocytic leukemia
10.3760/cma.j.issn.0253-2727.2022.09.005
- VernacularTitle:血小板输注无效在慢性粒-单核细胞白血病患者异基因造血干细胞移植后的发生率及临床意义
- Author:
Chen ZHAO
1
;
Xiaosu ZHAO
;
Yu WANG
;
Chenhua YAN
;
Lanping XU
;
Xiaohui ZHANG
;
Kaiyan LIU
;
Xiaojun HUANG
;
Yuqian SUN
Author Information
1. 北京大学人民医院，北京大学血液病研究所，国家血液系统疾病临床医学研究中心，造血干细胞移植北京市重点实验室，北京 100044
- Keywords:
Chronic myelomonocytic leukemia;
allogeneic hematopoietic stem cell transplantation;
Platelet transfusion refractoriness
- From:
Chinese Journal of Hematology
2022;43(9):738-744
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To retrospectively analyze the incidence and clinical significance of platelet transfusion refractoriness (PTR) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with chronic myelomonocytic leukemia (CMML) .Methods:A cohort of 55 CMML patients received allo-HSCT at Peking University Institute of Hematology during 2004-2021 were retrospectively assessed. The incidence of PTR within 30 days after allo-HSCT was retrospectively analyzed, and the impact on clinical outcomes and bleeding event were compared between patients with platelet transfusion refractoriness (PTR) or effective platelet transfusion (EPT) .Results:The incidence of PTR after allo-HSCT in CMML patients was 25.5% (14/55) . PTR patients had a lower rate of platelet engraftment than EPT patients (28.6% vs 100%) , and the median time of engraftment was 67 (33-144) days and 21 (9-157) days respectively ( P<0.010) . There was no significant difference between two groups in acute graft-versus-host disease (aGVHD) and chronic graft-versus-host disease (cGVHD) ( P=0.183, P=0.455) . After following-up a median of 684 (24-3978) days, the 1-year overall survival (OS) and 1-year leukemia free survival (LFS) in PTR and EPT patients were (35.4±13.9) % vs (75.1±7.8) % ( P=0.037) and (28.1±13.3) % vs (65.3±8.2) % ( P=0.072) , respectively. The transplant-related mortality (TRM) were (48.2±2.4) % and (9.0±0.25) %, respectively ( P=0.009) . Bleeding events occurred in five patients (35.7%) of PTR and 2 patients (4.9%) of EPT ( P=0.009) . Conclusion:In CMML patients with allo-HSCT, the incidence of PTR is 25.5%, which was associated with delayed platelet engraftment, increased bleeding events, inferior OS and increased TRM.
