Prophylactic platelet transfusion for prevention of bleeding in patients with haematological disorders after chemotherapy and stem cell transplantation

Abstract

These conclusions refer to the four different types of platelet transfusion trial separately. Firstly, there is no evidence that a prophylactic platelet transfusion policy prevents bleeding. Two large trials comparing a therapeutic versus prophylactic platelet transfusion strategy, that have not yet been published, should provide important new data on this comparison. Secondly, there is no evidence, at the moment, to suggest a change from the current practice of using a platelet count of 10 x 10(9)/L. However, the evidence for a platelet count threshold of 10 x 10(9)/L being equivalent to 20 x 10(9)/L is not as definitive as it would first appear and further research is required. Thirdly, platelet dose does not affect the number of patients with significant bleeding, but whether it affects number of days each patient bleeds for is as yet undetermined. There is no evidence that platelet dose affects the incidence of WHO grade 4 bleeding.Prophylactic platelet transfusions were more effective than platelet-poor plasma at preventing bleeding.

Platelet transfusions for critically ill patients with thrombocytopenia

“…This suggestion is supported by data from randomized trials in patients with chemotherapy-associated thrombocytopenia, which showed that platelet transfusions reduce the risk of serious bleeding when the platelet count is below 10 3 10 9 /L. 30,36 However, these data may not be generalizable to critically ill patients who have frequent comorbidities and commonly require invasive procedures. In addition to platelet count, the decision to transfuse platelets will depend on age, weight, and other hemostatic parameters.…”

Guidance on Platelet Transfusion for Patients With Hypoproliferative Thrombocytopenia

“…The systematic reviews used for this guideline are illustrated in Table 2. Three published systematic reviews were included [21][22][23], and 5 systematic reviews were conducted by the ICTMG. Two [24,25] of the 5 conducted systematic reviews are published as full articles.…”

Platelet-Derived Ectosomes Reduce NK Cell Function

“…In addition, PLT transfusion is indispensable in patients with congenital PLT disorders, disturbed hematopoiesis, or after myeloablative chemotherapy preceding hematopoietical stem cell transplantation (1)(2)(3). Many of these conditions are accompanied by an increased risk for infection related to trauma itself or neutropenia (4)(5)(6)(7).…”