Researchers from the United Kingdom and Australia have found that patients not receiving prophylactic platelet transfusions may be at higher risk for bleeding than patients receiving prophylactic platelet transfusions for platelet count levels below 10×10^9/L. Presenting their findings at the 2012 American Society of Hematology Meeting, the research team conducted a randomized trial among 600 adult patients with hematological malignancies and severe thrombocytopenia to determine if a policy of not providing prophylactic platelet transfusions would be non-inferior in safety and efficacy compared to a policy of providing prophylactic platelets. The team found that patients not receiving prophylactic platelets were slightly more likely to experience WHO grade 2-4 bleeding (50 vs. 43%) and had a shorter average time before first bleeding. In addition, patients who did not receive prophylactic platelets had longer periods of bleeding and increased number of days with low platelet counts. However, there was no significant difference in the period of thrombocytopenia, length of hospital stay, or the number of severe adverse events. Further research is needed to refine the use of prophylactic platelet transfusion among specific subgroups of patients.
1. Stanworth S, Estcourt L, Powter G, Kahan B, Dyer C, Bakrania L, Llewelyn C, Choo L, Bielby L, Norfolk D, Wood E, Murphy M. Abstract 1: The Effect of a No-Prophylactic Versus Prophylactic Platelet Transfusion Strategy on Bleeding in Patients with Hematological Malignancies and Severe Thrombocytopenia (TOPPS trial): A Randomized Controlled, Non-Inferiority Trial. American Society of Hematology Annual Meeting 2012. Atlanta, GA. https://ash.confex.com/ash/2012/webprogram/Paper48819.html, 2012.