Predictive value of plasma IL-1 β, IL-8 levels and clinical factors for platelet transfusion refractoriness in patients with pediatric cancer

Objective To investigate the effect of clinical factors and inflammatory markers on platelet transfusion refractoriness (PTR) in children with chemotherapy- induced thrombocytopenia (CIT) and evaluate their predictive value, so as to provide reference for mechanism study of PTR caused by non-immune factors in children with cancer and provide clinical guidance for reasonable and effective platelet transfusion in children. Methods A total of 60 CIT pediatric cancer patients from Children’s Hospital, Zhejiang University School of Medicine between November 2022 and February 2024 were selected as the study subjects, and divided into the PTR group (n=30) and the non-PTR group (n=30) to collect the clinical data and laboratory markers before platelet transfusion (Plt). Univariate and multivariate logistic regression analysis was used to analyze the influencing factors of PTR. The predictive value influencing factors of PTR was analyzed by receiver operating characteristic (ROC) curve. Results Plasma IL-1β concentration in PTR group was significantly higher than that in non-PTR group[67.43 pg/mL (29.38, 222.40) vs 36.38 pg/mL (17.27, 68.06); P<0.05]; plasma IL-8 concentration in PTR group was significantly higher than that in non-PTR group[60.97 pg/mL (39.07, 112.00) vs 25.23 pg/mL (5.00, 71.38); P<0.01]; and the interval from initiation of chemotherapy to platelet transfusion was significantly higher in the PTR group than in the non-PTR group[9.5 d (8.0, 12.0) vs 12.0 d (9.8, 13.2); P<0.05]. Multivariate logistic regression analysis showed that IL-8 concentration (OR=1.05, P<0.05) had a statistically significant effect on the occurrence of PTR. ROC curve analysis showed that plasma IL-1β concentration (Cut-off value: 64.88 pg/mL; AUC: 0.653[95% CI: 0.511-0.796]) and plasma IL-8 concentration (Cut-off value: 33.33 pg/mL; AUC: 0.754[95% CI: 0.631-0.878]) and the interval from initiation of chemotherapy to platelet transfusion (Cut-off value: 11.5 days; AUC: 0.669[95% CI: 0.529-0.810]) were statistically significant in predicting PTR. Conclusion Plasma IL-8 concentration is an independent risk factor for PTR, and plasma IL-1β, IL-8 concentration and interval from initiation of chemotherapy to platelet transfusion have predictive value for PTR.