May
2012

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

Estcourt L, Stanworth S, Doree C, et al.
Cochrane Database Syst Rev 2012;5:CD004269.
NATA Rating :
Review by : L. T. Goodnough
NATA Review

This latest in a series of reviews by the Cochrane Collaboration Group addresses evidence in the literature for prophylactic platelet transfusions in patients after myeloablative therapy for hematologic disorders.

Important conclusions:

1. There is no evidence that a prophylactic platelet transfusion policy prevents bleeding.

2. Important new data from two large clinical trials comparing a therapeutic vs. prophylactic transfusion strategy, will be forthcoming.

3. There is no evidence that platelet dose affects the incidence of bleeding (WHO Grade 4).

4. While it is not definitive that a platelet threshold for transfusion of 10,000/mm3 is equivalent to 20,000/mm3, there is no evidence at the moment to suggest a change from the current practice of using a platelet count of 10,000/mm3.

– Lawrence Tim Goodnough