Abstract：
Prolonged thrombocytopenia (PT) is a serious complication after haematopoietic stem cell transplantation (HSCT). PT has been suggested to be associated with an increased platelet transfusion requirement and poor outcomes after transplantation. Due to the complex mechanism of PT development, it is difficult to diagnose in the early post-transplant period. Our study aimed to identify an early predictive marker for PT after HSCT. Previous studies showed that the clinical utility of immature platelet fraction (IPF) predicts platelet recovery after chemotherapy and successful engraftment. However, the relationship between IPF and PT after HSCT remains unclear. Fifty-two patients with malignant haematological diseases who underwent HSCT were included in the study. We observed the kinetics of recovery of haematological parameters after transplantation and performed receiver operating characteristics (ROC) curve analysis using data from the 52 HSCT patients. The days to rise and peak of IPF, absolute IPF count (A-IPF) and highly fluorescent IPF (H-IPF) were almost synchronised in all patients, at day 10 and day 15, respectively. The begin to rise levels of IPF, H-IPF and A-IPF were all significantly lower in the PT group than in the good engraftment (GE) group (p=0.0016, p=0.0094, p=0.0086, respectively). The peak levels of IPF were significantly lower in the PT group than the GE group (p=0.0036). However, the peaks of H-IPF and A-IPF were not statistically significant between the two groups (p=0.3383, p=0.0887, respectively). The area under the ROC curve (AUC) of IPF rise was 0.739 (95% CI 0.583-0.896; p<0.05) and the cut-off value was 3.5%, while the AUC of IPF peak was 0.800 (95% CI 0.637-0.962; p<0.01) and the cut-off value was 8.0%. In conclusion, early low levels of IPF predict the development of PT after HSCT. These findings may help improve the management and treatment strategies for PT after HSCT.
摘要：
长期血小板减少症（PT）是造血干细胞移植（HSCT）后的严重并发症。PT已被认为与移植后血小板输注需求增加和不良预后有关。由于PT发展的复杂机制，在移植后的早期很难诊断。我们的研究旨在确定HSCT后PT的早期预测标志物。先前的研究表明，未成熟血小板部分（IPF）的临床效用可预测化疗和成功植入后的血小板恢复。然而,IPF与HSCT后PT之间的关系尚不清楚。该研究纳入了52例接受HSCT的恶性血液病患者。我们观察了移植后血液学参数恢复的动力学，并使用52例HSCT患者的数据进行了受试者工作特征（ROC）曲线分析。IPF上升和高峰的日子，绝对IPF计数（A-IPF）和高度荧光IPF（H-IPF）在所有患者中几乎同步，分别在第10天和第15天。IPF水平开始上升，PT组的H-IPF和A-IPF均显着低于良好植入（GE）组（分别为p=0.0016，p=0.0094，p=0.0086）。PT组的IPF峰值水平显著低于GE组(p=0.0036)。然而,两组间H-IPF和A-IPF峰值无统计学意义(分别为p=0.3383,p=0.0887).IPF升高的ROC曲线下面积（AUC）为0.739（95％CI0.583-0.896；p<0.05），临界值为3.5％，IPF峰的AUC为0.800(95%CI0.637-0.962;p<0.01)，临界值为8.0%。总之,早期低水平的IPF预测HSCT后PT的发展。这些发现可能有助于改善HSCT后PT的管理和治疗策略。
