Factors Influencing Corrected Count Increment After Platelet Transfusion in Thrombocytopenic Patients

Background Platelet transfusion is a life-saving procedure for thrombocytopenic patients. Platelet transfusions can be either prophylactic or therapeutic. Prophylactic platelet transfusion reduces the risk of bleeding before any specific procedure, whereas therapeutic platelet transfusion helps to control active bleeding. Evaluation of the response to platelet transfusion by calculating the corrected count increment (CCI) is important to determine the success of platelet transfusion and to plan subsequent patient management. Methods We conducted a prospective observational study in patients who received at least one unit of platelet concentrate (random donor platelet (RDP) or single donor platelet (SDP)) admitted under or seen by General Medicine. Patients over 60 years, multiparous females, and chemotherapy patients were excluded. The patient's pre-transfusion and post-transfusion platelet counts at one hour and 24 hours were taken, and CCI was calculated. Results We studied 60 patients during the study period, out of which 35 were males (58.33%) and 25 were females (41.67%). The mean age was 36.2 years, and the age range was from 15 to 60 years. The majority of patients were O-Rh positive (41.67%), followed by B-Rh positive (40%), A-Rh positive (11.67%), and least by AB-Rh positive (5%) and only one patient with O-Rh negative (1.67%). The logistic regression analysis showed that sepsis (p=0.025), splenomegaly (p=0.004), COVID-19 (p=0.016), dengue (p=0.028), systemic lupus erythematosus (SLE) (p=0.045), immune thrombocytopenic purpura (ITP) (p=0.003) and fever (p=0.007) significantly contributed to unsuccessful CCI. However, acute leukemia (p=0.238), active bleeding (p=0.147), disseminated intravascular coagulopathy (DIC) (p=0.952), aplastic anemia (AA) (p=0.114), and sickle cell disease (SCD) (p=0.739) did not show any statistical significance. Conclusion Unsuccessful CCI at 24 hours is attributed to non-immunological clinical factors like sepsis, splenomegaly, COVID-19, and fever, whereas immunological clinical factors like SLE, dengue, and ITP resulted in unsuccessful CCI at one hour, as evident by this study.