Clinical Factors Affecting Platelet Growth in the Treatment of Aplastic Anemia by Tonifying Kidney and Generating Blood
Authors: Liu Jian , Zhang Chao-Chang , Zhang Sheng-Qi , Wang Jin-Huan , Xu Rui-Rong , Yang Shu-Lian , Wang Tao , Liu Qi-Feng , Wang Hai-Xia , Tang Xu-Dong 
Published: December 2023

Objective:
To investigate the influence of kidney-tonifying and blood-generating method on platelet (PLT) growth in the treatment of aplastic anemia (AA) and analyze the characteristics of the clinical factors affecting PLT growth. We enrolled patients treated from September 2018 to March 2021 in the China Academy of Traditional Chinese Medicine (TCM) Xiyuan Hospital, China Academy of TCM hospital gate 19 sub-center. We enrolled 128 AA patients, for whom the inclusion criteria were: treatment is given priority to with kidney and heart’s-blood method, on the basis of western medicine treatment for kidney fill party avoid Fried instant particles, stay for 3 months for a period of treatment, taking two consecutive period of treatment, changes in the PLT were observed, and the clinical characteristics of AA patients, such as PLT growth and recovery from baseline value, were analyzed.

Materials and Methods:
A total of 128 AA patients from 19 branches of Xiyuan Hospital, China Academy of Chinese Medical Sciences and Guang’anmen Hospital, China Academy of Chinese Medical Sciences treated from September 2018 to March 2021 were enrolled. The treatment was based on the kidney-tonifying and blood-generating method and lasted for 3 months as a course of treatment. The changes in the number of PLT in patients were observed, and the clinical characteristics of AA affecting PLT growth and recovery from baseline value were analyzed.

Results:
After 6 months of treatment following the kidney-tonifying and blood-generating method, PLT increased from the baseline values in 75 cases, including 21 cases of AA with normal PLT recovery and 54 cases of AA without normal PLT recovery. There were 53 cases of AA in whom PLT did not increase from the baseline. Analysis of the general data showed that patients with lower Karnofsky Performance Status (KPS) score were more likely to experience PLT growth or even return to normal after therapy (P < 0.05). The results of routine blood analysis showed that when hemoglobin (HGB) was ≥60 g/L and the reticulocyte (RET) proportion was ≥0.3% before treatment, PLTs were more likely to increase, even returning to normal in some patients (P < 0.05). Analysis of bone puncture results before treatment showed that when the proliferation of nucleated cells was low or extremely low in bone puncture examination, with the proportion of granulocytes <40%, and the proportion of erythroid cells <20%, the treatment method was more effective at increasing PLT count (P < 0.05). Analysis of the chromosome karyotype results before treatment showed that when the chromosome karyotype was normal, PLTs were more likely to increase or even return to normal after treatment (P < 0.05). Analysis of T-lymphocyte subsets before treatment showed that when CD3+ human leukocyte antigen (HLA)-DR+ proportion was ≥30%, PLTs were more likely to increase or even return to normal (P < 0.05).

Conclusions:
AA patients with a low KPS score, higher HGB ≥60 g/L, RET proportion ≥0.3%, low or extremely low proliferation of nucleated cells, granulocytes proportion <40%, erythroid proportion <20%, normal chromosome karyotype, CD3+HLA-DR+ ≥30%, should be treated with a kidney-tonifying and blood-generating method. Such patients are more likely to show PLT growth and the values may even return to normal.