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Science China Life Sciences

, Volume 61, Issue 5, pp 569–577 | Cite as

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

  • Qiang Fu
  • Lanping Xu
  • Xiaohui Zhang
  • Yu Wang
  • Yingjun Chang
  • Kaiyan Liu
  • Xiaojun Huang
Research Paper

Abstract

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.

Keywords

platelet transfusion refractoriness unmanipulated haploidentical stem cell transplantation clinical outcomes PLT transfusion 

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Notes

Acknowledgements

We thank the faculty members who collected samples and analyzed the data. This work was supported by the National High Technology Research and Development Program of China (2013AA020401), and the National Natural Science Foundation of China (81470342).

Supplementary material

11427_2017_9110_MOESM1_ESM.docx (14 kb)
Table S1. Univariate analysis of factors affecting OS, LFS, TRM, relapse and aGVHD in patients

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Copyright information

© Science China Press and Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  • Qiang Fu
    • 1
  • Lanping Xu
    • 1
  • Xiaohui Zhang
    • 1
  • Yu Wang
    • 1
  • Yingjun Chang
    • 1
  • Kaiyan Liu
    • 1
  • Xiaojun Huang
    • 1
    • 2
  1. 1.Peking University People’s Hospital & Peking University Institute of HematologyBeijing Key Laboratory of HSCTBeijingChina
  2. 2.Peking-Tsinghua Center for Life SciencesBeijingChina

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