Abstract
Background
Poor platelet graft function (PPGF) is a common complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT), which was defined as consistent low platelet counts with recovery of the other two cell lines after transplantation. This status leads to an increased risk of life-threatening hemorrhage, frequent requirements of platelet transfusion and extended hospital stays. However, no optimal treatment has been recommended. This study investigated aspects of platelet recovery after allo-HSCT, including prognostic value and the effect of recombinant human thrombopoietin (rhTPO).
Methods
We reviewed 275 patients who received allo-HSCT in our center from January 2013 to June 2014. Of them, 135 (49.1%) patients had good platelet graft function (GPGF) and 140 (50.9%) had PPGF. The latter included 59 (21.5%) patients with primary PPGF and 81 (29.4%) with secondary PPGF. All analyses were performed using an SPSS software package.
Results
Multivariate analysis showed that male gender (P = 0.024), lower CD34+ cell count (P = 0.04), and no use of rhTPO (P < 0.001) were associated with PPGF. The 3-year OS rate of patients with PPGF (58%) was significantly less than that of patients with GPGF (82%; P < 0.001). The effect of rhTPO was further analyzed on prognosis of patients after allo-HSCT. Although no advantage was apparent when analyzing the entire cohort, for patients with myelodysplastic syndromes (MDS) and aplastic anemia (AA), rhTPO was associated with a significant survival advantage (P = 0.014).
Conclusions
Our data showed that PPGF after allo-HSCT was associated with a poor prognosis. Administration of rhTPO after allo-HSCT could promote platelet engraftment, and significantly improve the prognosis of patients with MDS and AA.
No relevant conflicts of interest to declare.
Author notes
Asterisk with author names denotes non-ASH members.
