title: Platelet recovery and transfusion needs after reduced intensity conditioning allogeneic peripheral blood stem cell transplantation.
abstract: OBJECTIVE
  The aim of this retrospective study was to assess platelet transfusion needs and the kinetics and predictive factors for platelet recovery after reduced-intensity conditioning (RIC) allogeneic hematopoietic stem cell transplantation (HSCT).
  
  
  METHODS
  The profile of platelet recovery and transfusion needs in the first 100 days after RIC allo-SCT from a human leukocyte antigen-identical sibling donor was analyzed in a single-center series of 166 consecutive patients.
  
  
  RESULTS
  Platelet recovery (>20g/L) was observed at a median of 9 days (range, 0-99 days) after allo-SCT. One-hundred forty-five patients could be assessed for platelet recovery at day +100, of which 99 (68%) had a platelet count >99g/L. In the multivariate analysis, a lower platelet counts before the start of conditioning, and occurrence of grade III to IV acute graft-vs-host disease significantly influenced day-100 platelet recovery >100 x 10(9)/L (odds ratio [OR] = 2.51; 95% confidence interval [CI], 1.13-5.61; p = 0.025; and OR = 7.6; 95% CI, 3.0-19.29; p = 0.00002, respectively). Eighty-three patients (50%) did not require any platelet transfusion during follow-up. Multivariate analysis found the following parameters to be significantly associated with platelet transfusion needs: conditioning regimen type (use of antithymoglobulin: OR = 3.96; 95% CI, 1.77-8.89; p = 0.008), platelet count prior to RIC administration (>144g/L; OR = 0.18; 95% CI, 0.08-0.39; p = 0.00001) and occurrence of grade III to IV acute GVHD (OR = 11.62; 95% CI, 4.01-33.66; p = 0.000006).
  
  
  CONCLUSIONS
  Overall, these observations show a lower rate of platelet transfusion and faster platelet recovery kinetics after RIC HSCT, but also highlight the negative effect of severe acute GVHD as a risk factor for increased need for platelet transfusions.
authors.affiliation: Unité de Transplantation et de Thérapie Cellulaire (UTTC), Département d' Hématologie, Institut Paoli-Calmettes, Marseille Cedex, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Prébet
authors.forename: Patrick
authors.initials: P
authors.lastname: Ladaique
authors.forename: Martin
authors.initials: M
authors.lastname: Ferrando
authors.forename: Christian
authors.initials: C
authors.lastname: Chabannon
authors.forename: Catherine
authors.initials: C
authors.lastname: Faucher
authors.forename: Hugues
authors.initials: H
authors.lastname: De Lavallade
authors.forename: Jean
authors.initials: J
authors.lastname: El-Cheikh
authors.forename: Sabine
authors.initials: S
authors.lastname: Furst
authors.forename: Norbert
authors.initials: N
authors.lastname: Vey
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Stoppa
authors.forename: Patrice
authors.initials: P
authors.lastname: Viens
authors.forename: Didier
authors.initials: D
authors.lastname: Blaise
authors.forename: Mohamad
authors.initials: M
authors.lastname: Mohty
mesh_terms: D000328:Adult; D000368:Aged; D001792:Blood Platelets / Q000166:cytology*; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000601:surgery*; D033581:Stem Cell Transplantation; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous