Response to apheretic platelet transfusion in children of acute lymphoblastic leukemia receiving induction chemotherapy: a cross-sectional study from Bangladesh.
Sushanta Kumar Basak, Mohammad Azmain Iktidar, Romana Chowdhury, Ayesha Khatun, Atiar Rahman, Sonia Shormin Miah, Sheikh Saiful Islam Shaheen, Sudeshna Mazumder
Author Information
Sushanta Kumar Basak: Sheikh Hasina National Institute of Burn and Plastic Surgery.
Mohammad Azmain Iktidar: Directorate General of Health Services (DGHS).
Romana Chowdhury: Department of Transfusion Medicine, Sirajul Islam Medical College.
Ayesha Khatun: Bangabandhu Sheikh Mujib Medical University, Dhaka.
Atiar Rahman: Bangabandhu Sheikh Mujib Medical University, Dhaka.
Sonia Shormin Miah: Bangabandhu Sheikh Mujib Medical University, Dhaka.
Sheikh Saiful Islam Shaheen: Bangabandhu Sheikh Mujib Medical University, Dhaka.
Sudeshna Mazumder: Chattogram Medical College Hospital, Chattogram, Bangladesh.
Background: Disease and therapy-related hypoproliferative thrombocytopenia is a significant barrier to managing acute lymphoblastic leukaemia (ALL) patients. To reduce the risk of haemorrhage, apheretic platelet transfusion is a modern, effective, and expensive option. Since most ALL patients in Bangladesh have financial constraints, this study can shed light on the magnitude of benefit regarding the effectiveness of apheretic platelet prophylactically and therapeutically in children of ALL receiving induction chemotherapy. Materials and methods: This observational cross-sectional study was conducted in the department of transfusion medicine and the department of paediatric haematology and oncology at a tertiary level hospital in Bangladesh from June 2020 to June 2021. A total of 33 cases of ALL were enroled in this study according to inclusion and exclusion criteria. After receiving written informed consent, relevant data were collected using a face-to-face interview with the guardian of the patients, thorough clinical examination, and relevant investigation. After the collection of all the required data, analysis was done by Stata (v.16). Results: Mean age of the patients was 7.39±4.46 (SD), ranging from 1 to 18 years. The majority of children were aged younger than or equal to 10 years (69.70%). Male children were slightly predominant (51.5%). Significant post-transfusion platelet increment (Median pre-transfusion count 16×10/μl vs. Median post-transfusion count 133×10/μl, <0.001) was observed. WHO bleeding grades also improved after apheretic platelet transfusion (<0.05). Age was a significant factor associated with corrected count increment (CCI) in both univariate and multivariate analysis. In subgroup analysis, age and gender were significant predictors of CCI in therapeutic transfusion group but not in prophylactic transfusion group. Conclusions: Significant improvement in bleeding status and platelet count was observed following apheretic platelet transfusion.
