Basak Sushanta Kumar, Iktidar Mohammad Azmain, Chowdhury Romana, Khatun Ayesha, Rahman Atiar, Miah Sonia Shormin, Shaheen Sheikh Saiful Islam, Mazumder Sudeshna
Sheikh Hasina National Institute of Burn and Plastic Surgery.
Directorate General of Health Services (DGHS).
Ann Med Surg (Lond). 2024 Feb 2;86(3):1346-1351. doi: 10.1097/MS9.0000000000001780. eCollection 2024 Mar.
Disease and therapy-related hypoproliferative thrombocytopenia is a significant barrier to managing acute lymphoblastic leukaemia (ALL) patients. To reduce the risk of haemorrhage, apheretic platelet transfusion is a modern, effective, and expensive option. Since most ALL patients in Bangladesh have financial constraints, this study can shed light on the magnitude of benefit regarding the effectiveness of apheretic platelet prophylactically and therapeutically in children of ALL receiving induction chemotherapy.
This observational cross-sectional study was conducted in the department of transfusion medicine and the department of paediatric haematology and oncology at a tertiary level hospital in Bangladesh from June 2020 to June 2021. A total of 33 cases of ALL were enroled in this study according to inclusion and exclusion criteria. After receiving written informed consent, relevant data were collected using a face-to-face interview with the guardian of the patients, thorough clinical examination, and relevant investigation. After the collection of all the required data, analysis was done by Stata (v.16).
Mean age of the patients was 7.39±4.46 (SD), ranging from 1 to 18 years. The majority of children were aged younger than or equal to 10 years (69.70%). Male children were slightly predominant (51.5%). Significant post-transfusion platelet increment (Median pre-transfusion count 16×10/μl vs. Median post-transfusion count 133×10/μl, <0.001) was observed. WHO bleeding grades also improved after apheretic platelet transfusion (<0.05). Age was a significant factor associated with corrected count increment (CCI) in both univariate and multivariate analysis. In subgroup analysis, age and gender were significant predictors of CCI in therapeutic transfusion group but not in prophylactic transfusion group.
Significant improvement in bleeding status and platelet count was observed following apheretic platelet transfusion.
疾病及治疗相关的血小板生成减少性血小板减少症是急性淋巴细胞白血病（ALL）患者治疗过程中的重大障碍。为降低出血风险，单采血小板输注是一种现代、有效但昂贵的选择。由于孟加拉国的大多数ALL患者存在经济限制，本研究能够阐明在接受诱导化疗的ALL儿童中，单采血小板预防性和治疗性应用的有效性所带来的益处程度。
本观察性横断面研究于2020年6月至2021年6月在孟加拉国一家三级医院的输血医学科以及儿科血液学和肿瘤学部门开展。根据纳入和排除标准，本研究共纳入33例ALL病例。在获得书面知情同意后，通过与患者监护人进行面对面访谈、全面的临床检查以及相关调查来收集相关数据。收集所有所需数据后，使用Stata（v.16）进行分析。
患者的平均年龄为7.39±4.46（标准差），年龄范围为1至18岁。大多数儿童年龄小于或等于10岁（69.70%）。男性儿童略占多数（51.5%）。观察到输血后血小板显著增加（输血前计数中位数为16×10/μl，输血后计数中位数为133×10/μl，<0.001）。单采血小板输注后，世界卫生组织出血分级也有所改善（<0.05）。在单因素和多因素分析中年龄都是与校正计数增加（CCI）相关的显著因素。在亚组分析中，年龄和性别是治疗性输血组中CCI的显著预测因素，但在预防性输血组中不是。
单采血小板输注后出血状态和血小板计数有显著改善。
