Platelet transfusion improves clot formation and platelet function in severely thrombocytopenic haematology patients.

Autor: Karlström C; Department of Medicine Huddinge, Center for Haematology and Regenerative Medicine (HERM), Karolinska Institutet, Stockholm, Sweden.; Medical Unit Haematology, Karolinska University Hospital, Stockholm, Sweden., Gryfelt G; Medical Unit Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden., Schmied L; Department of Medicine Huddinge, Center for Haematology and Regenerative Medicine (HERM), Karolinska Institutet, Stockholm, Sweden., Meinke S; Department of Medicine Huddinge, Center for Haematology and Regenerative Medicine (HERM), Karolinska Institutet, Stockholm, Sweden., Höglund P; Department of Medicine Huddinge, Center for Haematology and Regenerative Medicine (HERM), Karolinska Institutet, Stockholm, Sweden.; Medical Unit Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden.
Jazyk: angličtina
Zdroj: British journal of haematology [Br J Haematol] 2022 Jan; Vol. 196 (1), pp. 224-233. Date of Electronic Publication: 2021 Sep 16.
DOI: 10.1111/bjh.17820
Abstrakt: Prophylactic platelet (PLT) transfusion is a common practice in severely thrombocytopenic patients that reduces mortality, but responses to platelet transfusions are variable and difficult to predict in individual patients. In this prospective study, we evaluated the outcome of PLT transfusions in 40 patients with haematological malignancies, linking corrected count increment (CCI) to clot formation and agonist-induced platelet activation after transfusion. The CCI was highly variable between patients and 34% showed no response (1-h CCI < 7,5). Short time since the last PLT transfusion and extended storage time of the PLT product were linked to poor transfusion response, while patient sex, C-reactive protein or the number of chemotherapy cycles prior to transfusion did not influence transfusion outcome. High CCI and good PLT responsiveness to agonist stimulation predicted efficient clot formation in rotational thromboelastometry, but transfusion did not restore poor PLT function in patients to the level of healthy controls. Our study provides new insights into factors affecting PLT transfusion outcome in haematology patients with severe thrombocytopenia, and suggests that the thrombocytopenic environment, or disease-associated factors, may hamper platelet responsiveness.
(© 2021 The Authors. British Journal of Haematology published by British Society for Haematology and John Wiley & Sons Ltd.)
Databáze: MEDLINE
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