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CME Evaluation

Oral Communication Session

Diagnostics, OMICs and Advanced Technologies

Session: Artificial Intelligence and computational modeling

OC 24.3 - The trajectory of platelets is linked to the development of aGVHD after HSC transplantation

Sunday, June 23, 2024
15:15 – 15:30 ICT
Room: Ballroom B4

    Presenting Author(s)

  • Dan Feng, PhD Candidate

    Student
    State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College
    Tianjin, Tianjin, China (People's Republic)

    • Co-Author(s)

  • HW

    Hongtao Wang

    Research Associate Professor
    State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College
    Tianjin, Tianjin, China (People's Republic)

  • Jiaxi Zhou, Ph.D

    professor
    Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
    Tianjin, Tianjin, China (People's Republic)

  • EJ

    Erlie Jia

    Proffessor
    State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College
    Tianjin, Tianjin, China (People's Republic)

Background: Haploidentical hematopoietic stem cell transplantation (HID-HSCT) is crucial for curing Acute Myeloid Leukemia (AML). Acute graft-versus-host disease (aGVHD) is the most common complication after transplantation, significantly impacting prognosis. Previous studies have indicated that patients with poor platelet recovery within 100 days post-transplantation have a higher tendency for aGVHD. However, the relationship between platelet trajectories, especially in the early post-transplant period, and the occurrence of aGVHD remains unclear.

Aims: This study aims to explore the potential link between early post-transplant (day 0 to day 10) platelet trajectories and the occurrence of aGVHD.

Methods: The study involved 216 AML patients who underwent HID-HSCT and were divided into a training cohort (165 cases) and a validation cohort (111 cases). Group-based trajectory modeling (GBTM) categorized platelet trajectories during the early post-transplantation period, and parameters applicable to the study were established.

Results: GBTM identified three distinct platelet trajectories in the training cohort: low, medium, and high. Multivariate analysis showed that the low platelet trajectory was an independent risk factor for severe aGVHD (HR [95% CI]: 0.383 [0.212-0.692], P = 0.001). Furthermore, cumulative competing risk analysis demonstrated that the low platelet trajectory group had a significantly higher 100-day cumulative incidence rate of severe aGVHD(46.2% vs. 25.0% vs. 7.7%, P = 0.003).
In the validation cohort, patients were also grouped based on platelet trajectories using GBTM, and the low platelet trajectory group had a higher rate of severe aGVHD (37.5% vs. 12.5% vs. 8.3%, P = 0.030).

Conclusion(s): This study, for the first time, establishes a connection between changes in platelet trajectories and the prognosis of the disease, finding that patients with an early need for platelet transfusion are more prone to developing severe aGVHD. These findings shed light on platelet trajectories beyond the absolute count of platelets, implying significant implications in various diseases, and warranting further exploration in clinical work.