Platelet Transfusions Refractoriness in Patients with Oncological Diseases

Abstract

Introduction: the transfusion of platelet concentrates often fails in the platelet increase, called platelet refractoriness, which impairs the hemotherapy.

Objective: to determine the frequency of platelet refractoriness in oncological patients and identify some associated factors.

Methods: a descriptive, analytical and prospective study was carried out in 71 oncological patients who received platelet transfusion at “Vladimir Ilich Lenin” Hospital, since July 2012 until July 2013. Variables such as: packed platelet response, age, sex, location of malignant neoplasm, fever, splenomegaly, hemorrhage, history of previous transfusions, chemotherapy, radiotherapy, presence of HLA ,                 , immune complex were considered.                                           

Results: the frequency of platelet refractoriness was of 19.7 % with 14 identified cases, with a slight prevailing of females and the age between 35 and 59 years in all groups; 35.8 % of refractory patients had oncohematological diseases; 64.3 had fever;  whereas lung (19.3 %) and breast (17.5 %) cancer prevailing in non refractoriness individuals. Previous history of platelet transfusion was found in 85.7 % of patients with refractoriness and 50.8 % in the non-refractoriness. High levels of anti-HLA antibodies were found in 64.2 % of refractory patients and only in 29.8% of non-refractoriness patients.

Conclusions: platelet refractoriness is frequent in oncological patients. Fever, history of previous platelet transfusions and high levels of seric anti-HLA antibodies were the most important factors in the refractoriness development.

Keywords: transfusion, refractoriness, platelets.