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. 2022 Jul 11:12:940320.
doi: 10.3389/fonc.2022.940320. eCollection 2022.

Prognostic Value of Thrombocytopenia in Myelodysplastic Syndromes After Hematopoietic Stem Cell Transplantation

Hong Wang  1   2   3 , Jiaqian Qi  1   2   3 , Xueqian Li  1   2   3 , Tiantian Chu  1   2   3 , Huiying Qiu  1   2   3 , Chengcheng Fu  1   2   3 , Xiaowen Tang  1   2   3 , Changgeng Ruan  1   2   3 , Depei Wu  1   2   3   4 , Yue Han  1   2   3   4
Affiliations

Prognostic Value of Thrombocytopenia in Myelodysplastic Syndromes After Hematopoietic Stem Cell Transplantation

Hong Wang et al. Front Oncol. .

Abstract

Prolonged isolated thrombocytopenia (PT) is a common complication affecting the outcome of stem cell transplantation. In this study, we undertook a real-world study of 303 myelodysplastic syndrome (MDS) patients who received allogeneic hematopoietic stem cell transplantation (HSCT) between December 2007 and June 2018. 28.4% of MDS patients suffered from PT after HSCT. Survival analysis indicated that PT was associated with worse overall survival (OS) in MDS patients. The 2-year and 5-year OS in MDS patients with PT after HSCT were 49% and 47%, significantly worse than that of 68% and 60% in patients without PT (P=0.005). For RFS, patients with PT did not have an increased risk of disease relapse (P=0.964). After multivariate adjustment, PT was proved to be the independent risk factor associated with the worse OS (HR 1.49, 95% CI 1.00-2.21, P =0.048). We further analyzed risk factors associated with the occurrence of PT in MDS patients. Multiple logistic regression identified grade II-IV aGVHD, extensive chronic GVHD, hemorrhagic cystitis, and CMV activation as significant risk factors for developing PT. Among these variables, the Odds Ratio (OR) of grade II-IV aGVHD was the highest (P =0.001, OR: 2.65, 95% CI: 1.51-4.64). These data indicated the prognostic value of PT in MDS after HSCT. The identification of risk factors for PT may help improve patient management and lead to the design of effective treatment strategies.

Keywords: hematopoietic stem cell transplantation; myelodysplastic syndrome; prognosis; risk factor; thrombocytopenia.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
(A) Overall survival of MDS patients with and without PT; (B) Relapse free survival of MDS patients with and without PT. (C) Forest plot for hazard ratio of different risk factors on overall survival in MDS patients, as established using a Cox regression model.
Figure 2
Figure 2
Multivariable logistic regression model assessing risk factors for PT in MDS patients after HSCT.
See this image and copyright information in PMC

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References

    1. Bielski M, Yomtovian R, Lazarus HM, Rosenthal N. Prolonged Isolated Thrombocytopenia After Hematopoietic Stem Cell Transplantation: Morphologic Correlation. Bone Marrow Transplant (1998) 22(11):1071–6. doi: 10.1038/sj.bmt.1701499 - DOI - PubMed
    1. Bruno B, Gooley T, Sullivan KM, Davis C, Bensinger WI, Storb R, et al. . Secondary Failure of Platelet Recovery After Hematopoietic Stem Cell Transplantation. Biol Blood Marrow Transplant (2001) 7(3):154–62. doi: 10.1053/bbmt.2001.v7.pm11302549 - DOI - PubMed
    1. First LR, Smith BR, Lipton J, Nathan DG, Parkman R, Rappeport JM. Isolated Thrombocytopenia After Allogeneic Bone Marrow Transplantation: Existence of Transient and Chronic Thrombocytopenic Syndromes. Blood (1985) 65(2):368–74. doi: 10.1182/blood.V65.2.368.368 - DOI - PubMed
    1. Wang H, Huang M, Zhao Y, Qi JQ, Chen C, Tang YQ, et al. . Recombinant Human Thrombopoietin Promotes Platelet Engraftment and Improves Prognosis of Patients With Myelodysplastic Syndromes and Aplastic Anemia After Allogeneic Hematopoietic Stem Cell Transplantation. Biol Blood Marrow Transplant (2017) 23(10):1678–84. doi: 10.1016/j.bbmt.2017.06.010 - DOI - PubMed
    1. Sun YQ, He GL, Chang YJ, Xu LP, Zhang XH, Han W, et al. . The Incidence, Risk Factors, and Outcomes of Primary Poor Graft Function After Unmanipulated Haploidentical Stem Cell Transplantation. Ann Hematol (2015) 94(10):1699–705. doi: 10.1007/s00277-015-2440-x - DOI - PubMed