Abstract
Platelet transfusions have been widely available for almost 20 years, but there remain a number of important questions with regard to their optimal clinical application. In this article, I shall address myself to the still highly contentious debate surrounding the usage of prophylactic platelet transfusions. It is probably fair to state that at most centres in the USA where substantial numbers of leukaemic patients are treated a prophylactic transfusion policy is implemented but that this practice is not nearly so widespread in Britain. The discussion will centre on patients with acute leukaemia, primarily because this group currently receive the most active platelet support, but also because such published data that is available, refer almost entirely to leukaemic subjects. I shall begin by outlining the various arguments favouring prophylactic platelets and then give counterarguments for therapeutic transfusions. The three clinical trials which bear on this subject will be discussed together with some (as yet) unpublished data from this centre. The article will conclude with some recommendations which I feel emerge from the currently available data.
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References
Gaydos, L. A., Freireich, E. J. and Mantel, N. (1962). The quantitative relation between platelet count and haemorrhage in patients with acute leukaemia. N. Engl. J. Med., 266, 905
Harker, L. A. and Slichter, S. J. (1972). The bleeding time as a screening test for evaluation of platelet function. N. Engl. J. Med., 287, 155
Higby, D. J., Cohen, E., Holland, J. F. and Sinks, L. (1974). The prophylactic treatment of thrombocytopenic leukaemic patients with platelets: a double blind study. Transfusion, 14, 440
Alvarado, J., Djerassi, I. and Farber, S. (1965). Transfusion of fresh concentrated platelets to children with acute leukaemia. J. Paediatr., 67, 13
Murphy, S., Koch, P. A. and Evans, A. E. (1976). Randomized trial of prophylactic versus therapeutic platelet transfusion in childhood acute leukaemia. Clin. Res., 3, 379 A (abstract)
Solomon, J., Bofenkamp, T., Fahey, J. L., Chillar, R. K. and Beutler, E. (1978). Platelet prophylaxis in acute non-lymphoblastic leukaemia. Lancet, 1, 267
Ford, J. M. and Cullen, M. H. (1977). Prophylactic granulocyte transfusions. Exp. Haematol., 5, (Suppl 1), 65
Yankee, R. A., Graff, K. S., Dowling, R. and Henderson, E. S. (1973). Selection of unrelated compatible platelet donors by lymphocyte HLA-matching. N. Engl. J. Med., 288, 760
Duquesnoy, R. J., Filip, D. J., Rodey, G. E., Rimm, A. A. and Aster, R. H. (1977). Successful transfusion of platelets ‘mismatched’ for HFA antigens to alloimmunized thrombocytopenic patients. Am. J. Haematol., 2, 219
Schiffer, C. A., Aisner, J. and Wiernick, P. H. (1978). Frozen autologous platelet transfusion for patients with leukaemia. N. Kngl. J. Med., 299, 7
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© 1980 MTP Press Limited
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Ford, J.M. (1980). Should Prophylactic Platelets be given to Patients with Acute Leukaemia?. In: Lister, T.A., Malpas, J.S. (eds) Platelet Transfusion. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-8695-4_6
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DOI: https://doi.org/10.1007/978-94-009-8695-4_6
Publisher Name: Springer, Dordrecht
Print ISBN: 978-0-85200-248-3
Online ISBN: 978-94-009-8695-4
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