title: Prognostic importance of the platelet count 100 days post allogeneic bone marrow transplant.
abstract: We assessed the prognostic importance of the platelet count 100 days post transplant of 107 consecutive patients receiving ablative allogeneic bone marrow transplant (BMT) between 7/96 and 12/00 who survived at least 100 days. Diagnoses included AML (n=36), chronic myelogenous leukemia (n=27), NHL (n=14), ALL (n=16), MDS (n=9), aplastic anemia (n=3), and one Hodgkin's disease and myelofibrosis each. In total, 64% were in remission or in chronic phase or had aplastic anemia (good risk), and 36% had active disease at the time of transplant (bad risk). In all, 70% were matched sibling transplants and 30% were matched unrelated donor transplants. The mean follow-up for the patients remaining alive is 48 months. Survival was powerfully influenced by the 100-day platelet count: 4-year survival was 19% for patients with a platelet count <30 x 10(9)/l; 41% for patients with a platelet count of 30-50; and 72% for those with a platelet count >50 (P<0.001; log-rank test). In a multivariable analysis, the most powerful risk factors for mortality after allogeneic BMT were low 100-day platelet count (P<0.001) and bad risk disease (P=0.009). We conclude that the platelet count 100 days post transplant is a powerful predictor of overall survival.
authors.affiliation: Department of Hematology and Medical Oncology, Taussig Cancer Center, The Cleveland Clinic Foundation, Cleveland, OH 44195, USA. bolwelb@ccf.org
authors.forename: B
authors.initials: B
authors.lastname: Bolwell
authors.forename: B
authors.initials: B
authors.lastname: Pohlman
authors.forename: R
authors.initials: R
authors.lastname: Sobecks
authors.forename: S
authors.initials: S
authors.lastname: Andresen
authors.forename: S
authors.initials: S
authors.lastname: Brown
authors.forename: L
authors.initials: L
authors.lastname: Rybicki
authors.forename: V
authors.initials: V
authors.lastname: Wentling
authors.forename: M
authors.initials: M
authors.lastname: Kalaycio
mesh_terms: D000293:Adolescent; D000328:Adult; D001792:Blood Platelets / Q000502:physiology*; D016026:Bone Marrow Transplantation / Q000379:methods* / Q000401:mortality; D005500:Follow-Up Studies; D019337:Hematologic Neoplasms / Q000628:therapy; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D010976:Platelet Count; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors; D019172:Transplantation Conditioning / Q000379:methods; D014184:Transplantation, Homologous