Platelet transfusion refractoriness after T-cell-replete haploidentical transplantation is associated with inferior clinical outcomes  

作　　者：Qiang Fu Lanping Xu Xiaohui Zhang Yu Wang Yingjun Chang Kaiyan Liu Xiaojun Huang 

机构地区：[1]Peking University People's Hospital & Peking University Institute of Hematology, Beijing Key Laboratory of HSCT, Beijing 100044, China [2]Peking-Tsinghua Center for Life Sciences, Beijing 100044, China

出　　处：《Science China(Life Sciences)》2018年第5期569-577,共9页中国科学（生命科学英文版）

基　　金：supported by the National High Technology Research and Development Program of China (2013AA020401);the National Natural Science Foundation of China (81470342)

摘　　要：Haploidentical stem cell transplantation (haplo-SCT) has been an alternative source of bone marrow for patients without human leukocyte antigen (HLA)-matched donors. The aim of this study was to investigate the relationships between platelet transfusion refractoriness (PTR) and clinical outcomes in the setting of haplo-SCT. Between May 2012 and March 2014, 345 patients who underwent unmanipulated haplo-SCT were retrospectively enrolled. PTR occurred in 20.6% of all patients. Patients in the PTR group experienced higher transplant-related mortality (TRM, 43.7% vs. 13.5%, P<0.001), lower overall survival (OS, 47.9%vs. 76.3%, P<0.001) and lower leukemia-free survival (LFS, 47.9% vs. 72.3%, P<0.001) compared to patients in the non-PTR group. The multivariate analysis showed that PTR was associated with TRM (P=0.002), LFS (P<0.001), and OS (P<0.001).The cumulative incidences of PTR in patients receiving >12 platelet (PLT) transfusions (third quartile of PLT transfusions) were higher than in patients receiving either >6 (second quartile) or >3 (first quartile) PLT transfusions (56.1% vs. 41.6% vs. 28.2%,respectively; P<0.001). The multivariate analysis also showed that PTR was associated with the number of PLT transfusions(P<0.001). PTR could predict poor transplant outcomes in patients who underwent haploidentical SCT.Haploidentical stem cell transplantation （haplo-SCT） has been an alternative source of bone marrow for patients without human leukocyte antigen （HLA）-matched donors. The aim of this study was to investigate the relationships between platelet transfusion refractoriness （PTR） and clinical outcomes in the setting of haplo-SCT. Between May 2012 and March 2014, 345 patients who underwent unmanipulated haplo-SCT were retrospectively enrolled. PTR occurred in 20.6% of all patients. Patients in the PTR group experienced higher transplant-related mortality （TRM, 43.7% vs. 13.5%, P〈0.001）, lower overall survival （OS, 47.9%vs. 76.3%, P〈0.001） and lower leukemia-free survival （LFS, 47.9% vs. 72.3%, P〈0.001） compared to patients in the non-PTR group. The multivariate analysis showed that PTR was associated with TRM （P=0.002）, LFS （P〈0.001）, and OS （P〈0.001）.The cumulative incidences of PTR in patients receiving 〉12 platelet （PLT） transfusions （third quartile of PLT transfusions） were higher than in patients receiving either 〉6 （second quartile） or 〉3 （first quartile） PLT transfusions （56.1% vs. 41.6% vs. 28.2%,respectively; P〈0.001）. The multivariate analysis also showed that PTR was associated with the number of PLT transfusions（P〈0.001）. PTR could predict poor transplant outcomes in patients who underwent haploidentical SCT.

关 键 词：platelet transfusion refractoriness unmanipulated haploidentical stem cell transplantation clinical outcomes PLT transfusion 

分 类 号：R457.7[医药卫生—治疗学]