title: Impact of platelet transfusion on toxicity and mortality after hematopoietic progenitor cell transplantation.
abstract: BACKGROUND
  Thrombocytopenia occurs commonly after hematopoietic progenitor cell transplantation (HPCT) and is associated with potential morbidity and mortality. Few studies have examined the impact of platelet (PLT) transfusion on clinical outcomes in HPCT while optimal PLT transfusion strategies after HSCT remain uncertain.
  
  
  METHODS
  A retrospective single-center cohort study was conducted on 522 patients undergoing HPCT between January 2002 and December 2007. Associations between PLT transfusion events and clinical characteristics with transplant-related outcomes were assessed using univariate and multivariate analysis.
  
  
  RESULTS
  Mean number of PLT transfusion events before Day +60 posttransplant was 7.5 (95% confidence interval, 6.7-8.4) with greater number of events after allogeneic compared with autologous HPCT (p < 0.01). Univariate and multivariate analysis confirmed that the number of PLT transfusion events was associated with increased 100-day nonrelapse mortality (p < 0.01), posttransplant length of hospital stay (p < 0.01), need for intensive care unit admission (p < 0.01), and number of organs affected by severe toxicity (p < 0.01).
  
  
  CONCLUSIONS
  HPCT-related toxicity and mortality are associated with increased PLT transfusion events. Alternative strategies to reduce PLT transfusions after HPCT may warrant future study.
authors.affiliation: Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Grace
authors.initials: G
authors.lastname: Christou
authors.forename: Natasha
authors.initials: N
authors.lastname: Kekre
authors.forename: William
authors.initials: W
authors.lastname: Petrcich
authors.forename: Melanie
authors.initials: M
authors.lastname: Tokessy
authors.forename: Doris
authors.initials: D
authors.lastname: Neurath
authors.forename: Antonio
authors.initials: A
authors.lastname: Giulivi
authors.forename: Elianna
authors.initials: E
authors.lastname: Saidenberg
authors.forename: Sheryl
authors.initials: S
authors.lastname: McDiarmid
authors.forename: Harold
authors.initials: H
authors.lastname: Atkins
authors.forename: Isabelle
authors.initials: I
authors.lastname: Bence-Bruckler
authors.forename: Christopher
authors.initials: C
authors.lastname: Bredeson
authors.forename: Lothar
authors.initials: L
authors.lastname: Huebsch
authors.forename: Mitchell
authors.initials: M
authors.lastname: Sabloff
authors.forename: Dawn
authors.initials: D
authors.lastname: Sheppard
authors.forename: Jason
authors.initials: J
authors.lastname: Tay
authors.forename: Alan
authors.initials: A
authors.lastname: Tinmouth
authors.forename: David S
authors.initials: DS
authors.lastname: Allan
mesh_terms: D000328:Adult; D064591:Allografts; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D019337:Hematologic Neoplasms / Q000401:mortality* / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D017713:Platelet Transfusion / Q000401:mortality*; D015996:Survival Rate; D013921:Thrombocytopenia / Q000209:etiology / Q000401:mortality*; D013997:Time Factors