“7+3” induction chemotherapy

Efficacy of platelet transfusions during standard induction chemotherapy in patients with acute myeloid leukemia

SUPPORTIVE THERAPY , ,

Davaasambuu1, S.V. Gritsayev2, T.V. Glazanova2, S.A. Tiranova2, N.A. Potikhonova2, I.S. Martynkevtch2, and A.V. Chechetkin2

1 I.I. Mechnikov Northwest State Medical University, RF Ministry of Health, Saint Petersburg, Russian Federation

2 Russian Research Institute of Hematology and Transfusiology, RF FMBA, Saint Petersburg, Russian Federation

ABSTRACT

The efficacy of platelet transfusions that is mainly determined by the immunological mechanisms still depends on the non-immunological factors causing the low platelet count increment after transfusions. The objective of the study was to identify clinical and hematological parameters that were associated with the efficacy of the platelet transfusions during induction chemotherapy according to “7+3” regimen in the patients with acute myeloid leukemias (AML) The data on 41 patients (median age: 42) were analyzed. The platelet transfusion was considered efficacious when the 24-corrected platelet count increment was ³ 4.5 ´ 109/L. The patients were divided into 2 groups according to the efficacy ³ 50 % or < 50 %, respectively. The groups showed no significant difference with respect to the age, AML variants according to the WHO classification and ELN prognostic scale, the response to chemotherapy, or the median of overall survival (OS). At the same time, the portion of the patients with the bone marrow (BM) blasts of myeloid origin (M1 and M2 variants of AML according to FAB classification) was greater in the group with the platelet transfusion efficacy of ³ 50 %. In the group of < 50 % platelet transfusion efficacy, there was the greater portion of patients with BM blasts of monocytic origin (M4 and M5 variants according to FAB classification (p =.001). Also, the trend towards the decreased median of OS was noted in the patients with the pre-transfusion platelet count below 10 ´ 109/L (p =0.049).

Keywords: acute myeloid leukemia, “7+3” induction chemotherapy, platelet transfusion.

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