Journal of Blood Disorders & Transfusion

Abstract

The Significance of Immune and Non-immune Causes Associated with Platelet Refractoriness in Haemato-oncology Patients: A Systematic Review and Meta-Analysis

Xiangyu Long and Denise E. Jackson*

Platelet Transfusion Refractoriness (PTR) can be defined as failed to elevate the level of platelet after receiving repeated platelet transfusion. PTR can be seen in normal patients as well as haemato-oncology patients when treating thrombocytopenia and it’s related to increased morbidity and mortality rate. Various risk factors can lead to PTR development, including both immune and non-immune factors. There was no comprehensive review of risk factors associated with PTR in haemato-oncology patients previously. Therefore, this study aims to determine the significance of both immune and non-immune causes associated with PTR in patients with haematological malignancies. The systematic review was conducted with relevant articles searched from five databases from 2003 to 2023. The meta-analysis was conducted using Open Meta Analyst software with one-arm proportion (arcsine transformed proportion) under binary random effects model with maximum likelihood method. A total of nine studies were analysed. Statistically significant results were indicated in forest plots with levels of heterogeneity. Results demonstrated significant correlation between bleeding (44.33%; 35.04%), infection (68.04%; 17.95%), fever (67.01%), and PTR in haemato-oncology patients (39.34%; 8.26%). Small to moderate correlation between splenomegaly (28.21%), HLA alloantibody (17.40%) associated PTR in haemato-oncology patients. This study illustrated PTR was an important adverse condition, as well as bleeding, infection, and fever were strongly associated with PTR development in patients with haematological malignancies. Such conditions required monitoring throughout clinical management to ensure better outcomes for the patients.

Published Date: 2024-02-28; Received Date: 2024-01-22