Immature platelet fraction levels predict the development of prolonged thrombocytopenia after haematopoietic stem cell transplantation

IF 3.6 3区医学 Q1 PATHOLOGY

Pathology Pub Date : 2024-07-14 DOI:10.1016/j.pathol.2024.04.014

Jun Cao , Jun Qiu , Jieyu Jin , Sheng Zhang , Jiahui Qu , Mingyue Wang , Longwei Qiao , Yuting Liang

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Abstract

Prolonged thrombocytopenia (PT) is a serious complication after haematopoietic stem cell transplantation (HSCT). PT has been suggested to be associated with an increased platelet transfusion requirement and poor outcomes after transplantation. Due to the complex mechanism of PT development, it is difficult to diagnose in the early post-transplant period. Our study aimed to identify an early predictive marker for PT after HSCT. Previous studies showed that the clinical utility of immature platelet fraction (IPF) predicts platelet recovery after chemotherapy and successful engraftment. However, the relationship between IPF and PT after HSCT remains unclear. Fifty-two patients with malignant haematological diseases who underwent HSCT were included in the study. We observed the kinetics of recovery of haematological parameters after transplantation and performed receiver operating characteristics (ROC) curve analysis using data from the 52 HSCT patients.

The days to rise and peak of IPF, absolute IPF count (A-IPF) and highly fluorescent IPF (H-IPF) were almost synchronised in all patients, at day 10 and day 15, respectively. The begin to rise levels of IPF, H-IPF and A-IPF were all significantly lower in the PT group than in the good engraftment (GE) group (p=0.0016, p=0.0094, p=0.0086, respectively). The peak levels of IPF were significantly lower in the PT group than the GE group (p=0.0036). However, the peaks of H-IPF and A-IPF were not statistically significant between the two groups (p=0.3383, p=0.0887, respectively). The area under the ROC curve (AUC) of IPF rise was 0.739 (95% CI 0.583–0.896; p<0.05) and the cut-off value was 3.5%, while the AUC of IPF peak was 0.800 (95% CI 0.637–0.962; p<0.01) and the cut-off value was 8.0%. In conclusion, early low levels of IPF predict the development of PT after HSCT. These findings may help improve the management and treatment strategies for PT after HSCT.

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未成熟血小板分数水平可预测造血干细胞移植后出现长期血小板减少症的情况

血小板减少症（PT）是造血干细胞移植（HSCT）后的一种严重并发症。有研究表明，血小板减少症与血小板输注需求增加和移植后不良预后有关。由于 PT 的发生机制复杂，因此很难在移植后早期进行诊断。我们的研究旨在确定造血干细胞移植后 PT 的早期预测标志物。先前的研究表明，未成熟血小板分数（IPF）的临床实用性可预测化疗后血小板的恢复和成功移植。然而，造血干细胞移植后 IPF 与 PT 之间的关系仍不清楚。研究纳入了 52 名接受造血干细胞移植的恶性血液病患者。我们观察了移植后血液学参数的恢复动力学，并利用52名造血干细胞移植患者的数据进行了接收者操作特征曲线（ROC）分析。所有患者的IPF、IPF绝对计数（A-IPF）和高荧光IPF（H-IPF）的上升天数和峰值几乎同步，分别为第10天和第15天。PT组的IPF、H-IPF和A-IPF开始上升水平均显著低于良好移植（GE）组（分别为p=0.0016、p=0.0094、p=0.0086）。PT 组的 IPF 峰值水平明显低于 GE 组（p=0.0036）。然而，H-IPF 和 A-IPF 的峰值在两组之间没有统计学意义（分别为 p=0.3383 和 p=0.0887）。IPF 上升的 ROC 曲线下面积（AUC）为 0.739 (95% CI 0.583-0.896; p<0.05)，临界值为 3.5%，而 IPF 峰值的 ROC 曲线下面积（AUC）为 0.800 (95% CI 0.637-0.962; p<0.01)，临界值为 8.0%。总之，早期低水平的 IPF 可预测造血干细胞移植后 PT 的发展。这些发现可能有助于改善造血干细胞移植后 PT 的管理和治疗策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pathology 医学-病理学

CiteScore

6.50

自引率

2.20%

发文量

459

审稿时长

54 days

期刊介绍： Published by Elsevier from 2016 Pathology is the official journal of the Royal College of Pathologists of Australasia (RCPA). It is committed to publishing peer-reviewed, original articles related to the science of pathology in its broadest sense, including anatomical pathology, chemical pathology and biochemistry, cytopathology, experimental pathology, forensic pathology and morbid anatomy, genetics, haematology, immunology and immunopathology, microbiology and molecular pathology.