Abstract
Objectives: The beneficial effect of platelet transfusion on haemostasis is well established, but there is emerging evidence that platelet transfusion induces an inflammatory response in vascular endothelial cells. Background: We investigated haemostatic function and endothelial biomarkers before and after platelet transfusion in patients with acute myeloid leukaemia. Materials and Methods: Blood was sampled before, 1 and 24h after platelet transfusion. Primary and secondary haemostasis was evaluated by whole blood aggregometry (Multiplate) and thromboelastography (TEG). Endothelial biomarkers (sICAM-1, syndecan-1, sThrombomodulin, sVE-Cadherin) and platelet activation biomarkers (sCD40L, TGF-beta) were investigated along with haematology/biochemistry analyses. Results: Twenty-two patients were included. Despite continued low platelet counts, platelet transfusion normalised the median values of most TEG parameters and slightly increased platelet aggregation (all P<0·05). Endothelial biomarkers were not significantly affected by transfusion. The 1h sCD40L level correlated positively with Syndecan-1 and soluble thrombomodulin delta values, biomarkers of endothelial damage (both P=0·005). Conclusion: Platelet transfusion improved haemostasis, whereas post-transfusion increases in sCD40L were associated with endothelial damage, indicating that transfused platelets and platelet-derived pro-inflammatory mediators may have opposite effects on the endothelium.
| Original language | English |
|---|---|
| Journal | Transfusion Medicine |
| Volume | 25 |
| Issue number | 3 |
| Pages (from-to) | 174-83 |
| Number of pages | 10 |
| ISSN | 0958-7578 |
| DOIs | |
| Publication status | Published - 1 Jun 2015 |
Keywords
- Aged
- Biomarkers, Tumor
- CD40 Ligand
- Endothelium, Vascular
- Female
- Hemostasis
- Humans
- Leukemia, Myeloid, Acute
- Male
- Middle Aged
- Platelet Transfusion