Effect of platelet count and platelet transfusion on fever duration in patients with febrile neutropenia

Pediatr Hematol Oncol. 2022 Nov;39(8):736-746. doi: 10.1080/08880018.2022.2066236. Epub 2022 Jul 20.

Abstract

Platelets play a role in hemostasis, thrombosis, and vascular integrity. They also play a major role in the development of inflammation and the activation of immune responses. They have phagocytic activity, stimulate the secretion of immune modulators, and activate other immune cells, which results in platelet-neutrophil aggregation, platelet-induced neutrophil degranulation, and the formation of neutrophil extracellular traps. Data on 124 febrile neutropenia attacks were retrospectively examined. Patients' age, sex, diagnosis, and relapse history were obtained. The complete blood count levels on the first and last febrile day of the febrile neutropenia attacks, duration of fever, and number, type, and timing of thrombocyte suspension transfusions were recorded. The patients were divided into three groups according to the day of fever when the platelet suspension was administered (1 day, 2-3 days, and >3 days); the duration of fever was compared between the three groups. The fever duration of those who were transfused with platelet suspension on the first day of fever was found to be significantly shorter (p = 0.03 and p < 0.001, respectively). When treating a patient with febrile neutropenia, if thrombocyte suspension transfusion is indicated, transfusing thrombocytes in the first days of fever shortens the fever duration and improves the prognosis of febrile neutropenia attack, supporting the hypothesis that not only neutrophils but also platelets may play a role in fighting against microorganisms.

Keywords: Febrile neutropenia; immunothrombus; netosis; platelet-neutrophil relationship; thrombocytopenia.

MeSH terms

  • Febrile Neutropenia*
  • Fever / chemically induced
  • Fever / therapy
  • Humans
  • Platelet Count
  • Platelet Transfusion*
  • Retrospective Studies