Zhongguo linchuang yanjiu (Nov 2024)
Analysis of risk factors of ineffective platelet transfusion for leukemia and the predictive value of HLA-Ⅰ antibody and TGF-β1
Abstract
Objective To analyze the risk factors of ineffective platelet transfusion in leukemia, and explore the predictive value of human leukocyte antigen (HLA)-Ⅰ antibody and transforming growth factor-β1 (TGF-β1) for ineffective platelet transfusion in leukemia. Methods The clinical data of 108 patients with acute leukemia from January 2020 to September 2023 in Banan Hospital Affiliated to Chongqing Medical University were retrospectively analyzed. All patients were treated with platelet transfusion, and the expression of HLA-Ⅰ antibody and TGF-β1 was detected. The subjects were divided into ineffective group (38 cases) and effective group (70 cases) according to the effect of platelet transfusion.The general data, HLA-Ⅰ antibody and TGF-β1 of the two groups were compared, and the risk factors of ineffective platelet transfusion in leukemia were analyzed by logistic regression. The receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of HLA-Ⅰ antibody and TGF-β1 for ineffective platelet transfusion in leukemia. Results A total of 1 575 platelets were transfused in 108 patients, and the effective rate of platelet transfusion was 68.00% (1071/1575). Logistic regression results showed that the number of transfusions＞6 times, infection, active bleeding, low positive bacterial culture, positive HLA-Ⅰ antibody, platelet count before transfusion, low TGF-β1 level were risk factors affecting the ineffectiveness of platelet transfusion in leukemia patients (P＜0.05). ROC curve analysis showed that the AUC of HLA-Ⅰ antibody and TGF-β1 a lone and combined predicting the ineffectiveness of platelet transfusion in leukemia patients was 0.748, 0.712, 0.812, and the sensitivity was 83.20%, 74.30%, 93.80%, respectively, with the combined prediction being the highest. Conclusion Positive HLA-Ⅰ antibodies and low TGF-β1 levels are risk factors for ineffective platelet transfusion in leukemia. Targeted intervention schemes can be used to intervene in patients with the above factors, in order to further improve the effect of platelet transfusion.
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