A no-prophylaxis platelet-transfusion strategy for hematologic cancers.

Stanworth SJ, Estcourt LJ, Powter G, et al.
N Engl J Med 2013;368:1771-1780.
NATA Rating :
Review by : L. T. Goodnough
NATA Review

This trial randomly assigned hematology patients receiving intensive chemotherapy or undergoing hemopoietic stem-cell transplantation to either a no-prophylaxis platelet transfusion strategy or standard prophylaxis with platelet transfusions. The incidence of bleeding was lower in the prophylaxis group than in the no-prophylaxis group (43% vs. 50%). Only 59% of patients received a platelet transfusion in the no-prophylaxis group versus 89% in the prophylaxis group. The trial provides evidence for the benefit of prophylactic platelet transfusions in hematology patients in agreement with the results of a previous smaller trial from Germany (Wandt H et al. Lancet 2012;380:1309-16; Nataonline comment).

– Lawrence Tim Goodnough