付晓艳 1甄自达 1邱立娟 1张慧敏 1王孟键 1张帅行 1马曙轩1
作者信息
- 1. 首都医科大学附属北京儿童医院 输血科,北京 100045
- 折叠
摘要
Abstract
Objective To evaluate the platelet transfusion requirements in children with high-risk stage Ⅳ neuroblasto-ma undergoing autologous hematopoietic stem cell transplantation(ASCT),and to identify risk factors for increased transfu-sion needs and prolonged time to platelet transfusion independence.Methods This single-center retrospective clinical study included 96 children with high-risk stage Ⅳ neuroblastoma who underwent ASCT from January 2019 to May 2024 in our hospital.Relevant clinical data were collected and analyzed,including age,gender,body surface area,platelet count(PLT)on stem cell infusion day(day 0),conditioning regimen,CD34+stem cell dose,platelet transfusion requirements during transplantation,and time to platelet transfusion independence post-transplant.Results All 96(100%)children re-ceived transfusion after ASCT.From day 0 to transfusion independence,the median number of platelet transfusion was 3(2,4.50),and the median volume of platelet transfused was 3(2,4.25)units.Platelet transfusion was required in almost all children in pseudo-healing stage(day 4 to day 6)and polar stage(day 7 to day 14),with transfusion rates as high as 83.33%(n=80)and 100%(n=96),respectively.The median time to platelet transfusion independence post-transplant was 13(11,17)days.Multivariate analysis showed that PLT<100×109/L on day 0,platelet transfusion within one week be-fore ASCT,the use of"busulfan+melphalan"conditioning regimen,and CD34+stem cell dose<4.0×106/kg were associat-ed with significantly increased platelet requirements and numbers of transfusion(P<0.05).PLT<100×109/L on day 0,platelet transfusion within one week before ASCT,and CD34+stem cell dose<4.0×106/kg were associated with significantly delayed platelet transfusion independence(P<0.05).Age,sex,and blood type showed no statistically significant associa-tion(P>0.05)with post-transplant platelet transfusion requirements or time to transfusion independence in neuroblastoma patients.Conclusion This study provided quantitative data for platelet transfusion after ASCT in children with high-risk stage Ⅳ neuroblastoma,and identified PLT<100×109/L on day 0,platelet transfusion within one week before ASCT,CD34+stem cell dose<4.0×106/kg were risk factors for increased platelet transfusions and delayed transfusion independ-ence.Furthermore,the use of the BuMel(busulfan-melphalan)conditioning regimen was also found to contribute to in-creased transfusion requirements.关键词
神经母细胞瘤/自体造血干细胞移植/血小板输注/预处理方案Key words
neuroblastoma/autologous hematopoietic stem cell transplantation(ASCT)/platelet transfusion/condi-tioning regimen分类
医药卫生
