KORELASI MEAN PLATELET VOLUME (MPV) DONOR DENGAN PERCENTAGE PLATELET RECOVERY (PPR) PASCA TRANSFUSI THROMBOPHERESIS PASIEN KEGANASAN HEMATOLOGI DEWASA

Ahmad Khoirul Anwar, Dr.dr.Teguh Triyono M.Kes., Sp.PK (K) ; Dr.dr.Andaru Dahesihdewi M.Kes., Sp.PK(K)

2023 | Tesis | S2 Kedokteran Klinik

Latar belakang: Trombositopenia merupakan salah satu komplikasi keganasan hematologi dan membutuhkan transfusi trombosit. Transfusi menggunakan komponen thrombopheresis lebih dipilih dibanding dengan thrombocyte concentrates karena berbagai keuntungannya. Seleksi donor thrombopheresis dilakukan diantaranya dengan adanya pemeriksaan mean platelet volume (MPV). Nilai MPV yang tinggi menunjukkan trombosit besar pada donor lebih banyak dan diduga meningkatkan keberhasilan transfusi dimana salah satu indikatornya bisa dinilai dengan percentage platelet recovery (PPR)
Tujuan: Untuk mengevaluasi korelasi antara MPV donor dan PPR pasca transfusi thrombopheresis pada pasien dengan keganasan hematologi dewasa
Metode: Penelitian ini menggunakan desain observasional analitik dengan pendekatan potong lintang untuk mengetahui korelasi MPV donor dan efikasi transfusi thrombopheresis dilihat dari nilai percentage platelet recovery (PPR) pada pasien dengan keganasan hematologi sebagai indikator efikasi transfusi thrombopheresis. Penelitian ini dilakukan di RSUP Dr. Sardjito Yogyakarta. Pemeriksaan jumlah trombosit dan MPV dengan hematology analyzer Sysmex XN-550 dilakukan pada subjek donor thrombopheresis sebelum donasi. Jumlah trombosit diperiksa pada subjek pasien pra transfusi dan 1 jam pasca transfusi. Hasil PPR dihitung pada 1 jam pasca transfusi berdasarkan formula perhitungan PPR. Analisis statistik dilakukan dengan SPSS versi 26. Uji korelasi menggunakan analisis Spearman, berdasarkan uji normalitas data menurut uji Saphiro Wilk. Nilai p < 0>Hasil: : Sebanyak 44 subjek penelitian donor dan pasien diikutkan dalam penelitian ini. Semua subjek donor berjenis kelamin laki laki dengan median usia adalah 35,5 (22-61) tahun dan rerata nilai MPV adalah 10,2±1,14 fL. Sejumlah 28 orang subjek pasien berjenis kelamin laki-laki (63,6%) dan 16 wanita (36,4%) dengan median usia 50 (18-68) tahun dan median nilai PPR 34,49 (1,85-176,85) %. Pada pasien didapatkan tanda klinis inflamasi/infeksi dalam bentuk demam sebanyak 7 pasien (15,9%), perdarahan sebanyak 10 pasien (22,7%) dan splenomegali sebanyak 6 pasien (13,6%). Tidak terdapat korelasi yang signifikan antara MPV donor dan PPR dengan nilai r = 0,292 dan p = 0,055
Simpulan : Tidak terdapat korelasi antara MPV donor dan PPR pasca transfusi thrombopheresis pasien keganasan hematologi dewasa.

Background: One of the complications of hematological malignancies is thrombocytopenia leading to transfusion thrombocytopenia, mainly using thrombopheresis components compared to platelet concentrates as it relates to their usefulness. Thrombopheresis donor selection is done by examining the mean platelet volume (MPV). High MPV values indicate large platelets in more donors and are thought to increase transfusion success where one indicator can be assessed by percentage platelet recovery (PPR)
Objective: To evaluate the correlation between donor MPV and PPR post-transfusion thrombopheresis in patients with adult hematologic malignancies
Methods: This study used an observational analytic design with cross-sectional approach to determine the correlation of donor MPV and thrombopheresis transfusion efficacy seen from the percentage of platelet recovery (PPR) in patients with hematological malignancies as an indicator of the efficacy of transfusion thrombopheresis. This research was conducted at RSUP Dr. Sardjito Yogyakarta. Examination of platelet count and MPV with hematology analyzer Sysmex XN-550 performed on thrombopheresis donor subjects prior to donation. Platelet counts were examined in pre-transfusion patient subjects and 1 hour post-transfusion. The PPR result is calculated at 1 hour post-transfusion based on the PPR calculation formula. Statistical analysis was performed with SPSS version 26. Correlation test using Spearman analysis, based on data normality test by saphiro Wilk test. A value of p < 0>Results: A total of 44 donor research subjects and patients were included in this study. All donor subjects were male with median age of 35.5 (22-61) years and average MPV value of 10.2 ± 1.14 fL. A total of 28 patient subjects were male (63.6%) and 16 female (36.4%) with median age of 50 (18-68) years with a median PPR value of 34.49 (1.85-176.85) %. The patients showed clinical signs of inflammation/infection in the form of fever in 7 patients (15.9%), bleeding in 10 patients (22.7%) and splenomegaly in 6 patients (13.6%). There is no significant correlation between donor MPV and PPR with values r = 0.292 and p = 0.055
Conclusion: There is no correlation between donor MPV and PPR post transfusion thrombopheresis in adult hematological malignancy patients
Keywords: Hematology malignancy, donor thrombopheresis, thrombocytopenia, MPV,PPR

Kata Kunci : Keganasan hematologi, donor thrombopheresis, trombositopenia, MPV, PPR