Is platelet transfusion necessary in cirrhotic patients with splenomegaly?

Clinical efficacy of platelet transfusion therapy in patients with leukemia and analysis of risk factors for ineffective transfusion

Clinical efficacy of platelet transfusion therapy in patients with leukemia was investigated to analyze risk factors for ineffective transfusion. A total of 105 cases of patients with leukemia admitted to The First Affiliated Hospital of Bengbu Medical College from August 2016 to November 2018 were selected as research subjects. A total of 49 patients received transfusion of apheresis platelet suspension, and were group A. Fifty-six patients who received mixed multi-person platelet suspension were group B. The percentage plate recovery (PPR) and corrected count increment (CCI), interleukin-11 (IL-11) and soluble glycoprotein 130 (sgp130) levels were compared between the two groups, and the correlation of PPR and CCI with serum IL-11 and sgp130 levels was analyzed. Multivariate logistic regression was used to analyze the independent risk factors affecting ineffective transfusion in patients with leukemia. After transfusion, PPR and CCI in both groups were significantly higher than those before transfusion (P<0.05). IL-11 was significantly increased in both groups after transfusion, and sgp130 was significantly decreased in the two groups after transfusion (P<0.05). Serum IL-11 level in leukemia patients was positively correlated with PPR and CCI (r=0.7693, P<0.001), (r=0.7760, P<0.001), and serum sgp130 level in leukemia patients was negatively correlated with PPR and CCI (r=-0.7086, P<0.001), (r=-0.7733, P<0.001). There were differences between the effective group and the ineffective group in transfusion frequency, fever, infection and splenomegaly (P<0.05). Fever (OR, 0.382; 95% CI, 0.183-0.972) and infection (OR, 0.367; 95% CI, 0.140-0.956) were independent risk factors for ineffective transfusion. In conclusion, apheresis platelet or mixed multi-person platelet suspension transfusion can significantly improve the disorder of platelet count in patients with leukemia, and improve the clinical efficacy. Fever and infection are independent risk factors leading to ineffective transfusion.

Hypoplastic thrombocytopenia and platelet transfusion: therapeutic goals

Platelet transfusions consist a major part of the management of hypoplastic thrombocytopenia, the latter occurring mainly among patients with hematological malignancies. Platelet transfusions have led to a reduction of deaths attributable to thrombocytopenia-induced bleeding, despite their possible complications; nonetheless, prophylactic administration of platelets to patients with severe thrombocytopenia or before invasive procedures should be based on specific criteria, as well as therapeutic administration during active bleeding. Recently developed ex-vivo procedures have resulted in producing safer blood products, yet it remains unclear whether these pathogen-inactivated products have sufficient efficacy. What is more, another significant problem that remains to be more effectively addressed is the developing refractoriness to platelet transfusions.