Agonist-induced platelet reactivity correlates with bleeding in haemato-oncological patients
| Autor: | M. van Hamersveld, Rob Fijnheer, B. Batman, Suzanne J.A. Korporaal, Rolf T. Urbanus, Pieternel C. M. Pasker-de Jong, Mark Roest, E. R. van Bladel, Leonie A Boven |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Adult
Blood Platelets Male Agonist Median Fluorescence Intensity medicine.medical_specialty Low platelet count medicine.drug_class Antineoplastic Agents Hemorrhage Pilot Projects Platelet Transfusion 030204 cardiovascular system & hematology Gastroenterology Platelet function tests Platelet reactivity 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Journal Article Humans Platelet Flow cytometry Aged Coagulants Platelet Count business.industry General Medicine Odds ratio Hematology Middle Aged Platelet Activation Thrombocytopenia Confidence interval Leukemia Myeloid Acute Regimen Haemorrhage 030220 oncology & carcinogenesis Female business Haematology |
| Zdroj: | Vox Sanguinis, 112(8), 773. Wiley-Blackwell |
| ISSN: | 0042-9007 |
| Popis: | Background and objective Prophylactic platelet transfusions are administered to prevent bleeding in haemato-oncological patients. However, bleeding still occurs, despite these transfusions. This practice is costly and not without risk. Better predictors of bleeding are needed, and flow cytometric evaluation of platelet function might aid the clinician in identifying patients at risk of bleeding. This evaluation can be performed within the hour and is not hampered by low platelet count. Our objective was to assess a possible correlation between bleeding and platelet function in thrombocytopenic haemato-oncological patients. Materials and Methods Inclusion was possible for admitted haemato-oncology patients aged 18 years and above. Furthermore, an expected need for platelet transfusions was necessary. Bleeding was graded according to the WHO bleeding scale. Platelet reactivity to stimulation by either adenosine diphosphate (ADP), cross-linked collagen-related peptide (CRP-xL), PAR1- or PAR4-activating peptide (AP) was measured using flow cytometry. Results A total of 114 evaluations were available from 21 consecutive patients. Platelet reactivity in response to stimulation by all four studied agonists was inversely correlated with significant bleeding. Odds ratios (OR) for bleeding were 0·28 for every unit increase in median fluorescence intensity (MFI) [95% confidence interval (CI) 0·11–0·73] for ADP; 0·59 [0·40–0·87] for CRP-xL; 0·59 [0·37–0·94] for PAR1-AP; and 0·43 [0·23–0·79] for PAR4-AP. The platelet count was not correlated with bleeding (OR 0·99 [0·96–1·02]). Conclusion Agonist-induced platelet reactivity was significantly correlated to bleeding. Platelet function testing could provide a basis for a personalized transfusion regimen, in which platelet transfusions are limited to those at risk of bleeding. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text