Optimal dosing and triggers for prophylactic use of platelet transfusions

Current Opinion in Hematology

Volumn 6, Issue 6, 1999, Pages 437-441

  Rinder, Henry M ^a   Arbini, Arnaldo A ^a   Snyder, Edward L ^a  

^a YALE UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

MYELOABLATIVE AGENT; THROMBOCYTE CONCENTRATE;

ARTICLE; BLEEDING; COST EFFECTIVENESS ANALYSIS; DISSEMINATED INTRAVASCULAR CLOTTING; HUMAN; OUTPATIENT CARE; PRACTICE GUIDELINE; PRIORITY JOURNAL; PROPHYLAXIS; THROMBOCYTE TRANSFUSION; THROMBOCYTOPENIA;

HUMANS; PLATELET TRANSFUSION;

EID: 0032741081     PISSN: 10656251     EISSN: None     Source Type: Journal    
DOI: 10.1097/00062752-199911000-00015     Document Type: Article

References (16)

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4. 4 Hersh JK, Hom EG, Brecher ME: Mathematical modeling of platelet survival with implications for optimal transfusion practices in the chronically platelet-transfusion-dependent patient. Transfusion 1998, 38:637-644. The authors use a mathematical model to predict platelet survival. Using an interactive computer program, they assessed the effects of different transfusion thresholds and platelet doses; this information may be helpful for development of optimal platelet transfusion strategies.
5. 5 Bautista AP, Buckler PW, Towler HM, Dawson AA, Bennett B: Measurement of platelet life-span in normal subjects and patients with myeloproliferative disease with indium oxine labelled platelets. Br J Haematol 1984, 58:679-687.
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8. 8 Aderica D, Praff G, Santo M: Bleeding due to thrombocytopenia in acute leukemias and re-evaluation of the prophylactic platelet transfusion policy. Am J Med Sci 1986, 291:147-155.
9. 9 Gmur J, Burger J, Schanz U, Fehr J, Schaffner A: Safety of stringent prophylactic platelet transfusion policy for patients with acute leukemia. Lancet 1991, 338:1223-1224.
10. 10 Gil-Fernandez JJ, Alegre A, Fernandez-Villalta MJ, Pinilla I, Gomez-Garcia V, Martinez C, et al.: Clinical results of a stringent policy on prophylactic platelet transfusion: non-randomized comparative analysis on 190 bone marrow transplant patients from a single institution. Bone Marrow Transplant 1996, 18:931-935.
11. 11 Bernstein SH, Nademanee AP, Vose JM, Tricot G, Fay JW, Negrin RS, et al.: A multicenter study of platelet recovery and utilization in patients after myeloablative therapy and hematopoietic transplantation. Blood 1998, 91:3509-3517.
12. 12 Heckman KD, Weiner GJ, Davis CS, Strauss RG, Jones MP, Burns CP: Randomized study of prophylactic platelet transfusion threshold during induction therapy for adult acute leukemia: 10,000/μL versus 20,000/μL. J Clin Oncol 1997, 15:1143-1149.
13. 13 Rebulla P, Finazzi G, Marangoni F, Avvisati G, Gugliotta L, Tognoni G, et al.: The threshold for propylactic platelet transfusions in adults with acute myeloid leukemia. N Engl J Med 1997, 337:1870-1875.
14. 9/L trigger: a prospective comparative trial in 105 patients with acute myeloid leukemia. Blood 1998, 91:3601-3606. Although this was not a randomized comparison of the 10,000/μL and 20,000/μL triggers for prophylactic transfusion, this multicenter study found similar bleeding rates and erythrocyte transfusion amounts between the two groups. Serious bleeding requiring increased platelet transfusions occurred only in the high trigger group, but, even with this subset excluded, a significant reduction in total platelet requirements was still noted at the lower threshold.
15. 15 Sagmeister M, Oec L, Gmur J: A restrictive platelet transfusion policy allowing long-term support of outpatients with sever aplastic anemia. Blood 1999, 93:3124-3126. This study examined decreasing the threshold for prophylactic transfusion and lengthening the transfusion interval irrespective of counts in patients with severe aplastic anemia. With a 10,000/μL trigger for patients with complicated thrombocytopenia and a 5,000/μL trigger for those without bleeding risk factors, the transfusion interval could be increased to more than 7 days for consecutive outpatient transfusions and to 4 days for inpatient transfusions.
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