Assessment of Platelet Count Changes in Adult Acute Leukemia Patients Receiving Platelet Transfusions at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
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Date
2025-06
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Addis Ababa University
Abstract
Background: Many cancer patients, especially those with blood cancers like acute
Leukemia, face a serious risk of bleeding, which can lead to death. About 52% of
these patients have bleeding complications. The extent of optimal platelet transfusion
response is not well known, and the predictors of transfusion effectiveness remain
poorly understood. Therefore, assessing the factors influencing transfusion outcomes
is essential, yet research on this remains limited.
Objective: To assess of Platelet Count Changes in Adult Acute Leukemia Patients
Receiving Platelet Transfusions at Tikur Anbessa Specialized Hospital, Addis Ababa,
Ethiopia.
Methods: A facility-based cross-sectional study was conducted from December 2024
to May 2025 at Tikur Anbessa Specialized Hospital involving 174 adult acute
leukemia patients receiving platelet transfusions. Informed consent was obtained from
all participants. Blood samples were collected pre-transfusion, at 1 hour, and 24 hours
post-transfusion. Corrected count increment (CCI) was calculated by subtracting pretransfusion
platelet counts from post-transfusion counts, multiplying by the patient’s
body surface area (m²), and dividing by the total number of platelets transfused. An
optimal response was defined as a CCI ≥ 7.5 × 10⁹/L at 1 hour and ≥ 4.5× 10⁹/L at 24
hours. Logistic regression was used to identify predictors of CCI.
Result: Of the 174 patients, the mean age was 31.45 years, and 67.2% were male.
Acute lymphoblastic leukemia was more common (59.2%) than acute myeloid
leukemia. Overall, 81.7% and 68.6% of transfusions resulted in optimal CCI at 1 hour
and 24 hours, respectively. In multivariable analysis, not taking medication was
significantly negatively associated with achieving optimal CCI at 1 hour (AOR=0.54,
P=0.022). Additionally, new infection (AOR= 0.1248, P=0.003) were negatively
associated with optimal 1-hour CCI. An increase in the number of transfused platelet
units was significantly associated with decreased odds of achieving an optimal CCI at
24 hours (AOR = 0.027, p = 0.045 as the AOR was less than 1.
Conclusion: Most patients achieved optimal CCI post-transfusion. The unit of
transfused platelets was inversely associated with optimal CCI at 24 hours. Infection
and not taking medication were inversely associated with optimal 1-hour CCI. Future
longitudinal studies using incorporating immunological assessments are
recommended to understand predictors of optimal platelet increment change
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Keywords
Platlet Count, Acute Lukemia, Platlet transfusion