Clinical efficacy of platelet transfusion therapy in patients with leukemia and analysis of risk factors for ineffective transfusion

Chen,Li; Zhou,Hao; Guo ,Bo; Guan,Zheng

doi:10.3892/ol.2020.11268

Clinical efficacy of platelet transfusion therapy in patients with leukemia and analysis of risk factors for ineffective transfusion

Authors:
- Li Chen
- Hao Zhou
- Bo Guo
- Zheng Guan
View Affiliations

Affiliations: Department of Blood Transfusion, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233000, P.R. China
Published online on: January 24, 2020 https://doi.org/10.3892/ol.2020.11268
Pages: 2554-2561

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Clinical efficacy of platelet transfusion therapy in patients with leukemia was investigated to analyze risk factors for ineffective transfusion. A total of 105 cases of patients with leukemia admitted to The First Affiliated Hospital of Bengbu Medical College from August 2016 to November 2018 were selected as research subjects. A total of 49 patients received transfusion of apheresis platelet suspension, and were group A. Fifty-six patients who received mixed multi‑person platelet suspension were group B. The percentage plate recovery (PPR) and corrected count increment (CCI), interleukin‑11 (IL‑11) and soluble glycoprotein 130 (sgp130) levels were compared between the two groups, and the correlation of PPR and CCI with serum IL‑11 and sgp130 levels was analyzed. Multivariate logistic regression was used to analyze the independent risk factors affecting ineffective transfusion in patients with leukemia. After transfusion, PPR and CCI in both groups were significantly higher than those before transfusion (P<0.05). IL‑11 was significantly increased in both groups after transfusion, and sgp130 was significantly decreased in the two groups after transfusion (P<0.05). Serum IL‑11 level in leukemia patients was positively correlated with PPR and CCI (r=0.7693, P<0.001), (r=0.7760, P<0.001), and serum sgp130 level in leukemia patients was negatively correlated with PPR and CCI (r=‑0.7086, P<0.001), (r=‑0.7733, P<0.001). There were differences between the effective group and the ineffective group in transfusion frequency, fever, infection and splenomegaly (P<0.05). Fever (OR, 0.382; 95% CI, 0.183‑0.972) and infection (OR, 0.367; 95% CI, 0.140‑0.956) were independent risk factors for ineffective transfusion. In conclusion, apheresis platelet or mixed multi‑person platelet suspension transfusion can significantly improve the disorder of platelet count in patients with leukemia, and improve the clinical efficacy. Fever and infection are independent risk factors leading to ineffective transfusion.

View Figures

View References

1	Maertens J, Marchetti O, Herbrecht R, Cornely OA, Flückiger U, Frêre P, Gachot B, Heinz WJ, Lass-Flörl C, Ribaud P, et al Third European Conference on Infections in Leukemia, : European guidelines for antifungal management in leukemia and hematopoietic stem cell transplant recipients: Summary of the ECIL 3–2009 update. Bone Marrow Transplant. 46:709–718. 2011.PubMed/NCBI
2	Takami A, Yano S, Yokoyama H, Kuwatsuka Y, Yamaguchi T, Kanda Y, Morishima Y, Fukuda T, Miyazaki Y, Nakamae H, et al: Donor lymphocyte infusion for the treatment of relapsed acute myeloid leukemia after allogeneic hematopoietic stem cell transplantation: A retrospective analysis by the Adult Acute Myeloid Leukemia Working Group of the Japan Society for Hematopoietic Cell Transplantation. Biol Blood Marrow Transplant. 20:1785–1790. 2014.PubMed/NCBI
3	Roe JS, Mercan F, Rivera K, Pappin DJ and Vakoc CR: BET bromodomain inhibition suppresses the function of hematopoietic transcription factors in acute myeloid leukemia. Mol Cell. 58:1028–1039. 2015.PubMed/NCBI
4	Liu W and Freedman HI: A reaction-diffusion model of leukemia treatment by chemotherapy. Can Appl Math Q. 11:249–282. 2003.
5	Jiang L, Yu G, Meng W, Wang Z, Meng F and Ma W: Overexpression of amyloid precursor protein in acute myeloid leukemia enhances extramedullary infiltration by MMP-2. Tumour Biol. 34:629–636. 2013.PubMed/NCBI
6	Houwerzijl EJ, Blom NR, van der Want JJ, Louwes H, Esselink MT, Smit JW, Vellenga E and de Wolf JT: Increased peripheral platelet destruction and caspase-3-independent programmed cell death of bone marrow megakaryocytes in myelodysplastic patients. Blood. 105:3472–3479. 2005.PubMed/NCBI
7	Frinc I, Dima D, Chitic M, Berce C, Berindan-Neagoe I, Tat T, Tanase A, Tomuleasa C and Bojan A: Transthoracic ultrasonography for the follow-up of a chronic lymphocytic leukemia patient with chemotherapy-induced immunosuppression prior to allogeneic stem cell transplantation. A case report. Med Ultrason. 19:330–332. 2017.PubMed/NCBI
8	Just Vinholt P, Højrup Knudsen G, Sperling S, Frederiksen H and Nielsen C: Platelet function tests predict bleeding in patients with acute myeloid leukemia and thrombocytopenia. Am J Hematol. 94:891–901. 2019.PubMed/NCBI
9	Apelseth TO, Tor Hervig MD and Øystein Bruserud MD: Platelet transfusion in acute leukemia patients with severe chemotherapy-induced thrombocytopenia: The possible importance of hemoglobin levels and red blood cell transfusions for evaluation of clinical effects of transfusion. Transfusion. 50:2505–2506. 2010.
10	Wang Q, Du X, Yang M, Xiao S, Cao J, Song J and Wang L: LncRNA ZEB1-AS1 contributes to STAT3 activation by associating with IL-11 in B-lymphoblastic leukemia. Biotechnol Lett. 39:1801–1810. 2017.PubMed/NCBI
11	Richards PJ, Nowell MA, Horiuchi S, McLoughlin RM, Fielding CA, Grau S, Yamamoto N, Ehrmann M, Rose-John S, Williams AS, et al: Functional characterization of a soluble gp130 isoform and its therapeutic capacity in an experimental model of inflammatory arthritis. Arthritis Rheum. 54:1662–1672. 2006.PubMed/NCBI
12	Mason J and Griffiths M: Molecular diagnosis of leukemia. Expert Rev Mol Diagn. 12:511–526. 2012.PubMed/NCBI
13	Gmür J, Burger J, Schanz U, Fehr J and Schaffner A: Safety of stringent prophylactic platelet transfusion policy for patients with acute leukaemia. Lancet. 338:1223–1226. 1991.PubMed/NCBI
14	Hasegawa H, Nomura T, Kohno M, Tateishi N, Suzuki Y, Maeda N, Fujisawa R, Yoshie O and Fujita S: Increased chemokine receptor CCR7/EBI1 expression enhances the infiltration of lymphoid organs by adult T-cell leukemia cells. Blood. 95:30–38. 2000.PubMed/NCBI
15	Makaryus AN, Tung F, Liu W, Mangion J and Kort S: Extensive neoplastic cardiac infiltration in a patient with acute myelogenous leukemia: Role of echocardiography. Echocardiography. 20:539–544. 2003.PubMed/NCBI
16	Li Y, Azuma A, Takahashi S, Usuki J, Matsuda K, Aoyama A and Kudoh S: Fourteen-membered ring macrolides inhibit vascular cell adhesion molecule 1 messenger RNA induction and leukocyte migration: Role in preventing lung injury and fibrosis in bleomycin-challenged mice. Chest. 122:2137–2145. 2002.PubMed/NCBI
17	Noguchi T, Ikeda K, Yamamoto K, Ashiba A, Yoshida J, Munemasa M, Takenaka K, Shinagawa K, Ishimaru F, Yoshino T, et al: Severe bleeding tendency caused by leukemic infiltration and destruction of vascular walls in chronic neutrophilic leukemia. Int J Hematol. 74:437–441. 2001.PubMed/NCBI
18	Li JJ, Chen BA, Huang CY, Li CP, Shi GY, Xiao JY, Ding JH, Gao C, Sun YY, Wan J, et al: Test of activated plasma clotting time to assess efficacy of platelet transfusion. Exp Hematol. 15:108–111. 2007.
19	Balic JJ, Garbers C, Rose-John S, Yu L and Jenkins BJ: Interleukin-11-driven gastric tumourigenesis is independent of trans-signalling. Cytokine. 92:118–123. 2017.PubMed/NCBI
20	Zhang QR, Wu DP and Miao M: Level and clinical value of the plasma IL-11 and soluble gp130 in the patients with acute leukemia during the treatment of the induced remission. Zhongguo Shiyong Neike Zazhi. 17:1376–1378. 2007.(In Chinese).
21	Yan M and Jurasz P: The role of platelets in the tumor microenvironment: From solid tumors to leukemia. Biochim Biophys Acta. 1863:392–400. 2016.PubMed/NCBI
22	Ishikura H and Kitamura T: Trauma-induced coagulopathy and critical bleeding: The role of plasma and platelet transfusion. J Intensive Care. 5:22017.
23	Julmy F, Ammann RA, Mansouri Taleghani B, Fontana S, Hirt A and Leibundgut K: Effects of high-yield thrombocytapheresis on the quality of platelet products. Transfusion. 48:442–450. 2008.PubMed/NCBI
24	Wolf J, Waetzig GH, Chalaris A, Reinheimer TM, Wege H, Rose-John S and Garbers C: Different soluble forms of the interleukin-6 family signal transducer gp130 fine-tune the blockade of interleukin-6 Trans-signaling. J Biol Chem. 291:16186–16196. 2016.PubMed/NCBI
25	Lemmers A, Gustot T, Durnez A, Evrard S, Moreno C, Quertinmont E, Vercruysse V, Demetter P, Franchimont D, Le Moine O, et al: An inhibitor of interleukin-6 trans-signalling, sgp130, contributes to impaired acute phase response in human chronic liver disease. Clin Exp Immunol. 156:518–527. 2009.PubMed/NCBI
26	Gerstner JB, Smith MJ, Davis KD, Cimo PL and Aster RH: Post-transfusion purpura: Therapeutic failure of PlAl-negative platelet transfusion. Am J Hematol. 6:71–75. 1979.PubMed/NCBI
27	Tzadok S, Gurevich A, Inbal A, Bar-Natan M, Wolaj O and Raanani P: Continuous platelet transfusion increases platelet increment in refractory hemato-oncological patients. A Single Center Experience. Blood. 124:2888. 2014.
28	Yates SG and Sarode R: Is platelet transfusion necessary in cirrhotic patients with splenomegaly? Liver Int. 34:164–165. 2014.PubMed/NCBI
29	Hennewig U, Laws HJ, Eisert S and Göbel U: Bleeding and surgery in children with Glanzmann thrombasthenia with and without the use of recombinant factor VIIa. Klin Padiatr. 217:365–370. 2005.PubMed/NCBI
30	Beardsley DS, Chen BG and Kruglov O: A Mechanism for exacerbation of chronic ITP by infection: Toll-like receptor 4 (TLR4) activation enhances antibody-mediated platelet phagocytosis by human macrophages. Blood. 108:4802006.PubMed/NCBI