Risk factors of platelet refractoriness after thrombocyte concentrate transfusion in pediatric acute leukemia

Abstract

Children with acute leukemia often require platelet transfusions, but the platelet count frequently doesn't reach a satisfactory response, which is known as platelet refractoriness. This study aimed to analyze the risk factors for platelet refractoriness after thrombocyte concentrate transfusion in children with acute leukemia. An analytical observational study with a prospective approach, with subjects with acute leukemia who met the inclusion and exclusion criteria, at Dr. Soetomo General Hospital. Analysis with Chi-square test; Odds Ratio (OR), 95% confidence interval, multivariate Backward Wald method with p<0.05. There were 30 subjects, consisting of 19 subjects (63.3%) with platelet refractoriness, 11 subjects (36.7%) did not have platelet refractoriness. The significant differences factors are fever, splenomegaly, and antibiotic use with p values of 0.007; 0.004, and 0.049. There was no difference between gender, sepsis, heavy bleeding, chemotherapy, history of thrombocyte concentrate transfusion, and immature platelet fraction with the incidence of platelet refractoriness (p>0.05). Splenomegaly had a 5.333 times greater probability of platelet refractoriness after thrombocyte concentrate transfusion compared to those without splenomegaly in children with acute leukemia, (p=0.008), (OR 5.333; 95% CI 1.554 – 18.304). Splenomegaly is a risk factor for platelet refractoriness after thrombocyte concentrates transfusion in children with acute leukemia.