Association between platelet transfusion units and platelet transfusion refractoriness in patients with hematological...

Patients with hematologic diseases frequently receive platelet transfusions and exhibit a higher incidence of platelet transfusion refractoriness (PTR). This study assessed whether platelet transfusion units are a risk factor for PTR.

We enrolled 598 patients from the Hematology Department of Chengdu Second People's Hospital (Feb 2020-Feb 2023). Based on CCI values, patients were categorized into PTR (n = 207) and non-PTR (n = 391) groups. The relationship between platelet transfusion units and PTR risk was analyzed using logistic regression, with adjustments for confounders.

The PTR incidence was 34.61 %. Platelet transfusion units were significantly associated with increased PTR risk (OR=1.93, 95 % CI 1.67-2.24, p < 0.001); after adjusting for age, sex, infection, body mass index, disease classification, red blood cell transfusion units, and routine blood test results, this correlation increased higher (OR=2.35, 95 % CI 1.89-2.91, p < 0.001). The fitting curve between the platelet transfusion units and risk of PTR show a positive linear relationship(p = 0.472) Furthermore, when dividing platelet transfusion units into < 3 Units and ≥ 3 Units, patients receiving ≥ 3 Units had a significantly higher risk of PTR (OR=6.17, 95 % CI 4.24-8.97, p < 0.001) compared to those receiving < 3 Units; similarly, after adjusting for covariates, the risk of PTR in patients receiving ≥ 3 Units was still higher (OR=7.38, 95 % CI 4.29-12.69, p < 0.001). After propensity score matching, the risk remained robust (OR=4.59, 95 % CI 2.77-7.61, p < 0.001) across various model corrections.

Platelet transfusion units independently correlate with PTR incidence, suggesting the need for careful assessment and reduction of unnecessary transfusions.