Department of Clinical Pathology, University Health Network, Toronto, Ontario, Canada.
Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.
Pediatr Blood Cancer. 2020 Dec;67(12):e28734. doi: 10.1002/pbc.28734. Epub 2020 Sep 25.
Platelet transfusions are an essential aspect of supportive care for pediatric oncology patients. Data regarding the frequency of transfusions, pretransfusion thresholds, posttransfusion increments, and rate of platelet transfusion refractoriness (PTR) are lacking.
(a) describe platelet transfusion practice for children with malignancy; (b) determine the normal platelet increment following platelet transfusion; and (c) assess rate of PTR.
Inpatient pediatric oncology patients <18 years old and treated between 2009 and 2013 were identified. Data collected retrospectively included patient demographics, clinical information, laboratory values, and transfusion details.
Three hundred sixty-seven children were included and 144 (39%) received at least one platelet transfusion. Platelets were transfused during 25% of all inpatient admissions. The median number of platelet transfusion for any given inpatient admission was two (interquartile range [IQR]: 1-3). The median pretransfusion platelet count was 16 × 10 /L and posttransfusion increment was 25 × 10 /L. Most (79%) of the time, the pretransfusion platelet count was >10 × 10 /L. Older children who received ABO incompatible platelet transfusions with a longer storage duration were more likely to have a poor platelet response (increment ≤ 10 × 10 /L). The rate of PTR (immune and/or nonimmune) was low (8%; 11/144).
Practical information to parents and clinicians of newly diagnosed children regarding the likelihood and frequency of platelet transfusions was determined. The rate of PTR was low, supporting the hypothesis that children receiving leukoreduced products are at a low risk of PTR.
血小板输注是儿科肿瘤患者支持性治疗的重要组成部分。关于输注频率、输注前阈值、输注后增加量以及血小板输注抵抗（PTR）发生率的数据尚不清楚。
（a）描述恶性肿瘤儿童的血小板输注实践；（b）确定血小板输注后的正常血小板增加量；（c）评估 PTR 发生率。
回顾性确定 2009 年至 2013 年间收治的<18 岁的住院儿科肿瘤患者。收集的数据包括患者人口统计学信息、临床信息、实验室值和输血详细信息。
共纳入 367 例儿童，其中 144 例（39%）至少接受了一次血小板输注。血小板输注发生在 25%的住院患者中。每位住院患者的中位血小板输注次数为两次（四分位间距 [IQR]：1-3）。中位数输注前血小板计数为 16×10 /L，输注后增加量为 25×10 /L。大多数（79%）时间，输注前血小板计数>10×10 /L。接受 ABO 不相容血小板输注且储存时间较长的较大儿童更可能出现血小板反应不良（增加量≤10×10 /L）。PTR（免疫和/或非免疫）的发生率较低（8%；11/144）。
确定了向新诊断儿童的家长和临床医生提供关于血小板输注的可能性和频率的实用信息。PTR 发生率较低，支持接受白细胞减少产品的儿童发生 PTR 的风险较低的假设。
