High incidence of secondary failure of platelet recovery after autologous and syngeneic peripheral blood stem cell transplantation in acute promyelocytic leukemia.
Secondary failure of platelet recovery (SFPR), which is a delayed decline in platelet count after primary recovery following myeloablative hematopoietic SCT, is a significant problem in allogeneic SCT. However, its clinical characteristics have not been well described in autologous SCT for acute myeloid leukemia. We reviewed 11 consecutive patients who had received autologous or syngeneic SCT for acute promyelocytic leukemia. Seven of 11 patients (64%) had SFPR, which is defined as a decline in the platelet count to less than 30,000/microl for more than 7 days. The median onset of SFPR was day 36 (range, 25-51 days) and the median duration of thrombocytopenia was 13 days (range, 4-25 days). Of nine patients who received busulfan-containing preparative regimens, seven (78%) had SFPR and one had delayed primary platelet count recovery. Neither patient who received cyclophosphamide and total body irradiation as preparative regimens had SFPR. The clinical courses of SFPR were transient and self-limited. SFPR was not associated with relapse of underlying diseases, graft failure or other fatal morbidities. The unexpectedly high prevalence and the characteristics of SFPR may provide additional information on management following autologous SCT for acute myeloid leukemia.
Narimatsu
H
H
Department of Hematology and Oncology, JA Aichi Showa Hospital, Konan, Japan. narimt54@med.nagoya-u.ac.jp
Emi
N
N
Kohno
A
A
Iwai
M
M
Yanada
M
M
Yokozawa
T
T
Saito
S
S
Shimada
K
K
Kiyoi
H
H
Naoe
T
T
Yamamoto
K
K
Morishita
Y
Y
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects*; D010976:Platelet Count; D013921:Thrombocytopenia / Q000209:etiology*; D014182:Transplantation, Autologous; D014185:Transplantation, Isogeneic