J Korean Med Sci.  2006 Feb;21(1):46-51. 10.3346/jkms.2006.21.1.46.

Clinical Significance of Platelet Count at day +60 After Allogeneic Peripheral Blood Stem Cell Transplantation

• Kim DH
• Sohn SK
• Baek JH
• Kim JG
• Lee NY
• Won DI
• Suh JS
• Lee KB

• KMID: 2157781
• DOI: http://doi.org/10.3346/jkms.2006.21.1.46

Abstract

Thrombocytopenia (TP) is a frequent complication after allogeneic stem cell transplantation (SCT) and regarded as a poor prognostic factor, especially in patients with chronic graft-versus-host disease (GVHD), although various factors were related to the development of TP after allogeneic SCT. Sixty-three patients receiving allogeneic peripheral blood stem cell transplantation (PBSCT) were stratified according to platelet count (PC) at day +60 and analyzed in terms of overall survival (OS) and the incidence of non-relapse mortality (NRM). Ten patients (15.9%) were stratified in group 1 (PC < or =29 x 10(9)/L), 23 patients (36.5%) in group 2 (PC 30-79 x 10(9)/L), and 30 patients in group 3 (PC > or =80 x 10(9)/L). Group 3 was associated with lower incidence of extensive chronic GVHD (p=0.013), better 3-yr OS (p=0.0030), and lower NRM rate (p<0.0001). In multivariate analyses, the PC at day +60 was identified as an independent prognostic factor (p=0.003) together with CD34+ cell dose (p<0.001), disease risk (p=0.004), and acute GVHD (p=0.033) in terms of NRM, and the PC (p=0.047) and CD34+ cell dose (p=0.026) in terms of incidence of infectious events. Measuring the platelet count at day +60 is a simple method for predicting the risk of chronic GVHD development and prognosis after allogeneic PBSCT.

Keyword

Thrombocytopenia; Transplantation, Homologous; Allogeneic; Peripheral Blood Stem Cell Transplantation; Mortality; Opportunistic Infections

MeSH Terms

Adolescent
Adult
Antigens, CD34/blood
Female
Hematologic Diseases/blood/surgery
Humans
Male
Middle Aged
Multivariate Analysis
Neoplasms/blood/surgery
*Peripheral Blood Stem Cell Transplantation
Platelet Count
Prognosis
Survival Analysis
Time Factors
Transplantation, Homologous
Treatment Outcome

Figure

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  Fig. 1 Serial measurement of platelet count on day +30, +60, and +90 post-transplant.

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  Fig. 2 Overall survival and cumulative incidence of non-relapse mortality and infectious events.

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