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Secondary failure of platelet recovery after hematopoietic stem cell transplantation.

Publication ,  Journal Article
Bruno, B; Gooley, T; Sullivan, KM; Davis, C; Bensinger, WI; Storb, R; Nash, RA
Published in: Biol Blood Marrow Transplant
2001

After primary recovery of platelet counts after transplantation, there can be a late persistent decline called secondary failure of platelet recovery (SFPR), which may occur although the counts of other cell lineages remain within the normal range. SFPR was defined as a decline of platelet counts below 20,000/microL for 7 consecutive days or requiring transfusion support after achieving sustained platelet counts > or = 50,000/microL without transfusions for 7 consecutive days after hematopoietic stem cell transplantation (HSCT). The study population consisted of 2871 consecutive patients receiving transplants from January 1990 to March 1997. After primary recovery of platelet counts, SFPR not due to relapse of the underlying disease was observed in 285 of 1401 (20%) patients undergoing allogeneic transplantation and 36 (8%) of 444 patients undergoing autologous transplantation, with a median time of onset after transplantation at day 63 (range, day 21-156) and day 44 (range, day 24-89), respectively. Concomitant neutropenia was seen in 57 (20%) of 285 patients undergoing allogeneic HSCT and 7 (19%) of 36 patients undergoing autologous HSCT with SFPR. By multivariable analysis, the following were factors significantly associated with SFPR after allogeneic HSCT: a transplant from an unrelated donor; a graft-versus-host disease (GVHD) prophylaxis other than methotrexate and cyclosporine; development of grade 2 through 4 acute GVHD; impaired renal or liver function; conditioning with the combination of busulfan, cyclophosphamide, and total body irradiation; stem cell dose; and infections. Cytomegalovirus infection after engraftment and source of stem cells were the only significant risk factors after autologous HSCT. The hazard rate of death was significantly higher in patients who experienced SFPR (hazard ratio = 2.6 for allogeneic HSCT; hazard ratio = 2.2 for autologous HSCT). SFPR was associated with serious complications and poor outcome after transplantation. The identification of the characteristics and risk factors for SFPR could improve patient counseling and management and lead to the design of effective treatment strategies.

Duke Scholars

Published In

Biol Blood Marrow Transplant

DOI

ISSN

1083-8791

Publication Date

2001

Volume

7

Issue

3

Start / End Page

154 / 162

Location

United States

Related Subject Headings

  • Transplantation, Homologous
  • Transplantation, Autologous
  • Thrombocytopenia
  • Risk Factors
  • Platelet Transfusion
  • Platelet Count
  • Middle Aged
  • Male
  • Infant
  • Immunology
 

Citation

APA
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ICMJE
MLA
NLM
Bruno, B., Gooley, T., Sullivan, K. M., Davis, C., Bensinger, W. I., Storb, R., & Nash, R. A. (2001). Secondary failure of platelet recovery after hematopoietic stem cell transplantation. Biol Blood Marrow Transplant, 7(3), 154–162. https://doi.org/10.1053/bbmt.2001.v7.pm11302549
Bruno, B., T. Gooley, K. M. Sullivan, C. Davis, W. I. Bensinger, R. Storb, and R. A. Nash. “Secondary failure of platelet recovery after hematopoietic stem cell transplantation.Biol Blood Marrow Transplant 7, no. 3 (2001): 154–62. https://doi.org/10.1053/bbmt.2001.v7.pm11302549.
Bruno B, Gooley T, Sullivan KM, Davis C, Bensinger WI, Storb R, et al. Secondary failure of platelet recovery after hematopoietic stem cell transplantation. Biol Blood Marrow Transplant. 2001;7(3):154–62.
Bruno, B., et al. “Secondary failure of platelet recovery after hematopoietic stem cell transplantation.Biol Blood Marrow Transplant, vol. 7, no. 3, 2001, pp. 154–62. Pubmed, doi:10.1053/bbmt.2001.v7.pm11302549.
Bruno B, Gooley T, Sullivan KM, Davis C, Bensinger WI, Storb R, Nash RA. Secondary failure of platelet recovery after hematopoietic stem cell transplantation. Biol Blood Marrow Transplant. 2001;7(3):154–162.
Journal cover image

Published In

Biol Blood Marrow Transplant

DOI

ISSN

1083-8791

Publication Date

2001

Volume

7

Issue

3

Start / End Page

154 / 162

Location

United States

Related Subject Headings

  • Transplantation, Homologous
  • Transplantation, Autologous
  • Thrombocytopenia
  • Risk Factors
  • Platelet Transfusion
  • Platelet Count
  • Middle Aged
  • Male
  • Infant
  • Immunology