Risk factors of platelet refractoriness after thrombocyte concentrate transfusion in pediatric acute leukemia

Mellisa Kristanti Hosea; Mia Ratwita  Andarsini; I Dewa Gede Ugrasena; Adwina Nurlita Kusuma Wardhani; Andi Cahyadi; Maria Christina Shanty Larasati

doi:10.53730/ijhs.v6nS9.12562

Authors

Mellisa Kristanti Hosea Resident of Department of Child Health, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
Mia Ratwita Andarsini Department of Child Health, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
I Dewa Gede Ugrasena Department of Child Health, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
Adwina Nurlita Kusuma Wardhani Department of Child Health, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
Andi Cahyadi Department of Child Health, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
Maria Christina Shanty Larasati Department of Child Health, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.

Keywords:

Platelet Refractoriness, Transfusion, Thrombocyte Concentrate, Acute Leukemia, Children

Abstract

Children with acute leukemia often require platelet transfusions, but the platelet count frequently doesn't reach a satisfactory response, which is known as platelet refractoriness. This study aimed to analyze the risk factors for platelet refractoriness after thrombocyte concentrate transfusion in children with acute leukemia. An analytical observational study with a prospective approach, with subjects with acute leukemia who met the inclusion and exclusion criteria, at Dr. Soetomo General Hospital. Analysis with Chi-square test; Odds Ratio (OR), 95% confidence interval, multivariate Backward Wald method with p<0.05. There were 30 subjects, consisting of 19 subjects (63.3%) with platelet refractoriness, 11 subjects (36.7%) did not have platelet refractoriness. The significant differences factors are fever, splenomegaly, and antibiotic use with p values of 0.007; 0.004, and 0.049. There was no difference between gender, sepsis, heavy bleeding, chemotherapy, history of thrombocyte concentrate transfusion, and immature platelet fraction with the incidence of platelet refractoriness (p>0.05). Splenomegaly had a 5.333 times greater probability of platelet refractoriness after thrombocyte concentrate transfusion compared to those without splenomegaly in children with acute leukemia, (p=0.008), (OR 5.333; 95% CI 1.554 – 18.304). Splenomegaly is a risk factor for platelet refractoriness after thrombocyte concentrates transfusion in children with acute leukemia.

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References

Amarullah, A., Hasmono, D., Airlangga, U. (2013). Analysis of Adrenal Suppression After High Dose Prednisone Therapy on Children With Standard Risk Acute Lymphoblastic Leukemia in Induction. Folia Medica Indonesiana, 54(1), 59–63.

Abuelgasim, K. A., ashed AlHumaid, S. R. A., AlOtaibi, A. S., & Yosra Z Ali, M. A. A. (2017). Platelet Transfusion Refractoriness among Patients with Hematological Malignancies in a Tertiary Center in Saudi Arabia. Journal of Oncology Translational Research, 02(01). https://doi.org/10.4172/2476-2261.1000112.

Bercovitz, R. S., & Josephson, C. D. (2012). Thrombocytopenia and bleeding in pediatric oncology patients. Hematology. American Society of Hematology. Education Program, 2012, 499–505. https://doi.org/10.1182/asheducation-2012.1.499.

Cahyadi, A., Ugrasena, I.D., Andarsini, M., Larasati, M., Aryati, A., Arumsari, D. (2022). Relationship between Bax and Bcl-2 Protein Expression and Outcome of Induction Phase Chemotherapy in Pediatric Acute Lymphoblastic Leukemia. Asian Pacific Journal of Cancer Prevention. 23, 1679–1685. https://doi.org/10.31557/apjcp.2022.23.5.1679

Curtis, B. R., Kaliszewski, J., Marques, M. B., Saif, M. W., Nabelle, L., Blank, J., McFarland, J. G., & Aster, R. H. (2006). Immune-mediated thrombocytopenia resulting from sensitivity to oxaliplatin. American Journal of Hematology, 81(3), 199–201. https://doi.org/10.1002/ajh.20516.

Delaflor-Weiss, E., & Mintz, P. D. (2000). The evaluation and management of platelet refractoriness and alloimmunization. Transfusion Medicine Reviews, 14(2), 180–196. https://doi.org/10.1016/S0887-7963(00)80007-3.

Ferreira, A. A., Zulli, R., Soares, S., de Castro, V., & Moraes-Souza, H. (2011). Identification of platelet refractoriness in oncohematologic patients. Clinics, 66(1), 35–40. https://doi.org/10.1590/S1807-59322011000100007.

Forest, S. K., & Hod, E. A. (2016). Management of the Platelet Refractory Patient. Hematology/Oncology Clinics of North America, 30(3), 665–677. https://doi.org/10.1016/j.hoc.2016.01.008.

Fayzullaeva, H. D. (2020). Educational environment influence on the pre-school children’s social cognition development. International Journal of Social Sciences and Humanities, 4(2), 13–20. https://doi.org/10.29332/ijssh.v4n2.401

Have, L. W. J., Hasle, H., Vestergaard, E. M., & Kjaersgaard, M. (2013). Absolute immature platelet count may predict imminent platelet recovery in thrombocytopenic children following chemotherapy. Pediatric Blood & Cancer, 60(7), 1198–1203. https://doi.org/10.1002/pbc.24484.

Hod, E., & Schwartz, J. (2008). Platelet transfusion refractoriness. British Journal of Haematology, 142(3), 348–360. https://doi.org/10.1111/j.1365-2141.2008.07189.x.

Kapoor, G., Singh, N. (2018). Role of apoptotic markers in paediatric acute lymphoblastic leukaemia. Indian Journal of Medical Research. 147, 225. https://doi.org/10.4103/ijmr.IJMR_906_17

KEMENKES. (2011). Pedoman Penemuan Dini Kanker Pada Anak. KEMENKES.

Kerkhoffs, J.-L. H., Eikenboom, J. C. J., van de Watering, L. M. G., van Wordragen-Vlaswinkel, R. J., Wijermans, P. W., & Brand, A. (2008). The clinical impact of platelet refractoriness: correlation with bleeding and survival. Transfusion, 48(9), 1959–1965. https://doi.org/10.1111/j.1537-2995.2008.01799.x.

Kesehatan, K., & dan Pengembangan Kesehatan, B. P. (2018). Hasil Utama Riskesdas 2018. In Kementerian Kesehatan Republik Indonesia.

Kumawat, V., Sharma, R., Malhotra, P., & Marwaha, N. (2015). Prevalence of risk factors for platelet transfusion refractoriness in multitransfused hemato-oncological patients at tertiary care center in North India. Asian Journal of Transfusion Science, 9(1), 61. https://doi.org/10.4103/0973-6247.150953.

Lanzkowsky, P., Lipton, J.M., Fish, J.D. (2011). Lanzkowsky’s Manual of Pediatric Hematology and Oncology.

Levi, M. (2005). Platelets in sepsis. Hematology, 10(sup1), 129–131. https://doi.org/10.1080/10245330512331390177.

Milan, T., Canaj, H., Villeneuve, C., Ghosh, A., Barabé, F., Cellot, S., & Wilhelm, B. T. (2019). Pediatric leukemia: Moving toward more accurate models. Experimental Hematology, 74, 1–12. https://doi.org/10.1016/j.exphem.2019.05.003.

Petz, L. D., Garratty, G., Calhoun, L., Clark, B. D., Terasaki, P. I., Gresens, C., Gornbein, J. A., Landaw, E. M., Smith, R., & Cecka, J. M. (2000). Selecting donors of platelets for refractory patientson the basis of HLA antibody specificity. Transfusion, 40(12), 1446–1456. https://doi.org/10.1046/j.1537-2995.2000.40121446.x.

Pui, C.-H., Robison, L.L., Look, A.T. (2008). Acute lymphoblastic leukaemia. Lancet, 371, 1030–1043. https://doi.org/10.1016/S0140-6736(08)60457-2

Purba, J., Mulatsih, S., Nurani, N., & Triyono, T. (2013). Risk factors of platelet refractoriness in children. Journal of Thee Medical Sciences (Berkala Ilmu Kedokteran), 45(01), 36–44. https://doi.org/10.19106/JMedScie004501201305.

Schiffer, C. A., Lee, E. J., Ness, P. M., & Reilly, J. (1986). Clinical evaluation of platelet concentrates stored for one to five days. Blood, 67(6), 1591–1594. http://www.ncbi.nlm.nih.gov/pubmed/3708155.

Schmoeller, D., Picarelli, M. M., Paz Munhoz, T., Poli de Figueiredo, C. E., & Staub, H. L. (2017). Mean Platelet Volume and Immature Platelet Fraction in Autoimmune Disorders. Frontiers in Medicine, 4. https://doi.org/10.3389/fmed.2017.00146.

Shehata, N., Tinmouth, A., Naglie, G., Freedman, J., & Wilson, K. (2009). ABO-identical versus nonidentical platelet transfusion: a systematic review. Transfusion, 49(11), 2442–2453. https://doi.org/10.1111/j.1537-2995.2009.02273.x.

Slichter, S. J. (2005). Factors affecting posttransfusion platelet increments, platelet refractoriness, and platelet transfusion intervals in thrombocytopenic patients. Blood, 105(10), 4106–4114. https://doi.org/10.1182/blood-2003-08-2724.

Stanworth, S. J., Navarrete, C., Estcourt, L., & Marsh, J. (2015). Platelet refractoriness-practical approaches and ongoing dilemmas in patient management. British Journal of Haematology, 171(3), 297–305. https://doi.org/10.1111/bjh.13597.

Solórzano-Vélez, A. V., & Barreiro-Vera, B. A. (2022). Comprehensive training in the language, affective and social development of children at the Santa Martha Child Development Center in Chone Canton in 2022. International Research Journal of Management, IT and Social Sciences, 9(4), 587-597. https://doi.org/10.21744/irjmis.v9n4.2124

Subash, S., & Umesh, D. (2018). Effectiveness of platelet transfusion in acute leukemic pediatric patients: a prospective study. International Journal of Contemporary Pediatrics, 5(3), 824. https://doi.org/10.18203/2349-3291.ijcp20181407.

Syahbani, P., Andarsini, M. R., Utomo, M. T., & Bintoro, S. U. (2022). Analisis Faktor yang Mempengaruhi Kejadian Leukemia Limfoblastik Akut (LLA) pada Anak di RSUD Dr. Soetomo. Jurnal Kesehatan Masyarakat Indonesia, 17(2). https://doi.org/10.26714/jkmi.17.2.2022.38-47.

Suryasa, I. W., Rodríguez-Gámez, M., & Koldoris, T. (2021). Get vaccinated when it is your turn and follow the local guidelines. International Journal of Health Sciences, 5(3), x-xv. https://doi.org/10.53730/ijhs.v5n3.2938

Tinmouth, A. T., Semple, E., Shehata, N., & Branch, D. R. (2006). Platelet Immunopathology and Therapy: A Canadian Blood Services Research and Development Symposium. Transfusion Medicine Reviews, 20(4), 294–314. https://doi.org/10.1016/j.tmrv.2006.05.008.

Utomo, F.N., Yulistiani, Y., Zairina, N., Permono, B. (2017). Methotrexate Use Is Safe in Children With Acute Lymphoblastic Leukemia. Folia Medica Indonesiana, 53(2), 144-151. https://doi.org/10.20473/fmi.v53i2.6431