Prophylactic platelet transfusions.
Estcourt LJ., Stanworth SJ., Murphy MF.
PURPOSE OF REVIEW: This review highlights the recent research on the use of prophylactic platelet transfusions, which is a topic that still provokes controversy. Over the last 12 months, there have been several studies with important new findings. RECENT FINDINGS: Two randomized controlled trials compared different doses of prophylactic platelet transfusions in patients with haematological malignancies. In neonates, platelet mass has been used as a trigger for prophylactic platelet transfusions rather than the morning platelet count; and interim results of a therapeutic vs. a prophylactic platelet-transfusion strategy in acute myeloblastic leukaemia have been published. SUMMARY: Low-dose prophylactic platelet transfusions are as effective in the prevention of bleeding as high-dose platelets. Fewer platelets were transfused but more frequent transfusions were required. Platelet mass as a transfusion trigger led to a lower prophylactic platelet requirement and did not increase the risk of bleeding in thrombocytopenic neonates. The interim results of the trial of a therapeutic vs. a prophylactic transfusion strategy were unable to provide any firm conclusion about their relative effectiveness and further information is required from ongoing trials.