Platelet decrease and efficacy of platelet-rich plasma return following peripheral blood stem cell apheresis

Background: Peripheral blood stem cell (PBSC) transplantation is a key treatment option for hematological diseases and is widely performed in clinical practice. Platelet loss is one of the major complications of PBSC apheresis, and platelet-rich plasma (PRP) return is considered in case of platelet decrease following apheresis; however, little is known about the frequency and severity of platelet loss and the efficacy of PRP return postapheresis. Methods: We assessed changes in platelet counts following PBSC-related apheresis in 270 allogeneic (allo)- and 105 autologous (auto)-PBSC settings. We also evaluated the efficacy of PRP transfusion on platelet recovery postapheresis. Results: In both allo- and auto-PBSC settings, the preapheresis platelet count (range, 84-385 and 33-558 × 10⁹/L, respectively) decreased postapheresis (range, 57-292 and 20-429 × 10⁹/L, respectively), whereas severe platelet decrease (<50 × 10⁹/L) was only observed in auto-PBSC patients (n = 9). We confirmed that platelet count before apheresis was a risk factor for severe platelet decrease (<50 × 10⁹/L) following auto-PBSC apheresis (odds ratio 0.749, P <.049). PRP return postapheresis facilitated platelet recovery in more than 80% of cases in both allo and auto settings. Conclusion: Lower platelet count preapheresis is a useful predictor of severe platelet decrease following auto-PBSC apheresis and PRP return is an effective process to facilitate platelet recovery postapheresis.