Investigation of patient factors associated with the number of transfusions required during chemotherapy for high‐risk neuroblastoma
Investigation of patient factors associated with the number of transfusions required during chemotherapy for high‐risk neuroblastoma
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高危神经母细胞瘤化疗期间所需输血次数相关患者因素的调查
DOI：
10.1111/vox.13128
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发表时间：
2022
期刊：
影响因子：
2.7
通讯作者：
Tozuka Minoru
中科院分区：
文献类型：
--
作者：
Konno Saori;Yanagisawa Ryu;Kubota Noriko;Ogiso Yoshifumi;Nishimura Noriyuki;Sakashita Kazuo;Tozuka Minoru
背景输血是高危神经母细胞瘤的重要支持治疗。当输血次数增加时，输血相关不良反应可能会更严重。然而，决定骨髓抑制的程度和输血的数量在化疗高危neuroblastoma.Materials和MethodsWe调查患者因素的因素，确定在15个高危neuroblastoma患者接受化疗的5个疗程所需的输血数量。临床数据，细胞因子谱和集落形成测定与诊断时的骨髓标本进行了analysed.ResultsThe所需的血小板和红细胞的输血次数减少一次，在第二个过程中，然后增加的过程中的进展。随着化疗进程的进展，病例间的变异性增加。在诊断时外周血血小板计数和纤维蛋白原水平较低的病例中，化疗期间血小板输注次数较高。结论在化疗早期，神经母细胞瘤骨髓浸润和/或凝血功能障碍并发症可引起血小板减少，需要输注血小板;相反，在后期阶段，红细胞输注的数量可由患者固有的造血能力来确定。这些因素可能有助于预测所需的输血次数。
BackgroundBlood transfusion is an important supportive care for high‐risk neuroblastoma. When the number of transfusions increases, transfusion‐associated adverse reactions may be more problematic. However, the factors determining the degree of myelosuppression and the number of transfusions during chemotherapy for high‐risk neuroblastoma remain unclear.Materials and MethodsWe investigated patient factors determining the number of required transfusions in 15 high‐risk neuroblastoma patients who received five courses of chemotherapy. Clinical data, cytokine profile and colony‐forming assay with bone marrow samples at diagnosis were analysed.ResultsThe required number of transfusions of both platelets and erythrocytes decreased once in the second course and then increased as the course progressed. The variability among cases increased as the chemotherapy course progressed. In cases of low peripheral blood platelet count and lower fibrinogen level at diagnosis, the number of platelet transfusions was higher during chemotherapy. In contrast, there was a negative correlation between the forming ability of granulocyte–macrophage or erythroid colonies and the number of erythrocyte transfusions in the latter period.ConclusionIn the early stages of chemotherapy, bone marrow infiltration in neuroblastoma and/or coagulopathy complication may cause thrombocytopenia and requirement of platelet transfusion; conversely, in the later stages, the number of erythrocyte transfusions may be defined by the patient's inherent hematopoietic ability. These factors may be useful in predicting the required number of transfusions.
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