Platelet Refractoriness Evaluation after Platelet Concentrate Transfusion in Pediatric Leukemia

Abstract

Platelet transfusion is being used in 67%-75% of hematology malignancies including leukemia. Platelet refractoriness is the failure to achieve satisfactory responses to platelet transfusions. Many transfusion centres use 1 hour and 24 hours after transfusion Corrected Count Increment (CCI) value to define platelet refractoriness. To analyze platelet refractory based on CCI-1h and CCI-24h value after Platelet Concentrate (PC) tranfusion in pediatric leukemia and the effect of non immune factors on platelet refractoriness. Subjects were evaluated for platelet count after 10-120 minutes and 18-24 hours of PC tranfusion to calculate CCI-1h and CCI-24h. Platelet Refractoriness was defined when CCI-1h <5×109/L and CCI-24h <4.5×109/L. Each subject was observed for non-immune platelet refractory factors. Interestingly, from 25 PC transfusion there was 20% platelet refractoriness of CCI-1h and 40% of CCI-24h. There was a significant difference CCI-1h and CCI-24h (p=0.027). Non immune factor had no effect for platelet refractoriness. Platelet count should be analyzed after 24 hours PC transfusion to diagnose platelet refractoriness. Further research including immune factor examination is needed.