A multicenter study of platelet recovery and utilization in patients after myeloablative therapy and hematopoietic stem cell transplantation.
An observational study was conducted at 18 transplant centers in the United States and Canada to characterize the platelet recovery of patients receiving myeloablative therapy and stem cell transplantation and to determine the clinical variables influencing recovery, determine platelet utilization and cost, and incidence of hemorrhagic events.
The study included 789 evaluable patients transplanted in 1995.
Clinical, laboratory, and outcome data were obtained from the medical records.
Variables associated with accelerated recovery in multivariate models included (1) higher CD34 count ; (2) higher platelet count at the start of myeloablative therapy ; (3) graft from an HLA-identical sibling donor ; and (4) prior stem cell transplant.
Variables associated with delayed recovery were (1) prior radiation therapy ; (2) posttransplant fever ; (3) hepatic veno-occlusive disease ; and (4) use of posttransplant growth factors.
Disease type also influenced recovery.
Recipients of peripheral blood stem cells (PBSC) had faster recovery and fewer platelet transfusion days than recipients of bone marrow (BM).
The estimated average 60-day platelet transfusion cost per patient was $4,000 for autologous PBSC and $11,000 for allogeneic BM transplants.
It was found that 11% of all patients had a significant hemorrhagic event during the first 60 days posttransplant, contributing to death in 2% of patients. (...)
Mots-clés Pascal : Thrombocyte, Transfusion, Autogreffe, Greffe, Homogreffe, Moelle osseuse, Cellule hématopoïétique, Cellule souche, Sang, Hémorragie, Complication, Etude multicentrique, Etude cohorte, Epidémiologie, Etats Unis, Amérique du Nord, Amérique, Myélosuppression, Homme, Appareil circulatoire pathologie, Vaisseau sanguin pathologie
Mots-clés Pascal anglais : Platelet, Transfusion, Autograft, Graft, Homograft, Bone marrow, Hematopoietic cell, Stem cell, Blood, Hemorrhage, Complication, Multicenter study, Cohort study, Epidemiology, United States, North America, America, Myelosuppression, Human, Cardiovascular disease, Vascular disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0286629
Code Inist : 002B27D02. Création : 27/11/1998.