Department of Laboratory Medicine, West China Second University Hospital, Sichuan University , Chengdu , Sichuan , P. R. China.
Pediatric department of Hematology, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University , Chengdu , Sichuan , P.R. China.
Platelets. 2019;30(7):923-926. doi: 10.1080/09537104.2018.1548011. Epub 2018 Nov 29.
The time to platelet recovery (TPR) is becoming a predicting factor during the treatment of childhood acute leukaemia. However, the initial pre-treatment platelet count (PPC) could interfere with TPR. Here, we integrated both TPR and PPC as the average daily platelet amount increase (Ap) to predict the prognosis in childhood B-ALL during the recovery period.148 patients were enrolled. The relationship between the Ap and MRD was evaluated, and Multivariate analysis was performed to evaluate whether Ap was independently associated with a better EFS. The PPC was inversely correlated with TPR (s = -0.519, = 0.021). Patients in Ap >3.9 × 10/L group had better EFS ( = 3.109, = 0.028) than TPR ≤ 16d. Multivariate analysis indicated that Ap > 3.9 × 10/L was independently associated with a longer EFS (RR = 3.468; 95%CI: 1.037-11.597, = 0.043). However, when introducing both MRD and Ap > 3.9 × 10/L as candidate variables, the Ap > 3.9 × 10/L lost its independent effect ( = 0.081). The strong association between MRD on treatment day 33 and Ap > 3.9 × 10/L ( = 148.00, = 0.000) was responsible for this phenomenon. Ap could be a valuable prognostic indicator in childhood B-ALL.
血小板恢复时间（TPR）正在成为儿童急性白血病治疗中的一个预测因素。然而，初始治疗前血小板计数（PPC）可能会干扰 TPR。在这里，我们将 TPR 和 PPC 整合为平均每日血小板增加量（Ap），以预测儿童 B-ALL 恢复期的预后。共纳入 148 例患者。评估了 Ap 与 MRD 的关系，并进行了多变量分析，以评估 Ap 是否与 EFS 更好相关。PPC 与 TPR 呈负相关（s=-0.519， =0.021）。Ap＞3.9×10/L 组患者的 EFS 更好（ =3.109， =0.028），而 TPR≤16d 组患者的 EFS 较差。多变量分析表明，Ap＞3.9×10/L 与更长的 EFS 独立相关（RR=3.468；95%CI：1.037-11.597， =0.043）。然而，当引入 MRD 和 Ap＞3.9×10/L 作为候选变量时，Ap＞3.9×10/L 失去了独立作用（ =0.081）。这种现象是由于治疗第 33 天 MRD 与 Ap＞3.9×10/L 之间的强关联所致（ =148.00， =0.000）。Ap 可能是儿童 B-ALL 的一个有价值的预后指标。
