Should Prophylactic Platelets be given to Patients with Acute Leukaemia?

  • J. M. Ford


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 The three clinical trials which bear on this subject will be discussed together with some (as yet) unpublished data from this centre.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.


Platelet Count Acute Leukaemia Platelet Transfusion Contentious Debate Central Nervous System Bleeding 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    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, 905PubMedCrossRefGoogle Scholar
  2. 2.
    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, 155PubMedCrossRefGoogle Scholar
  3. 3.
    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, 440PubMedCrossRefGoogle Scholar
  4. 4.
    Alvarado, J., Djerassi, I. and Farber, S. (1965). Transfusion of fresh concentrated platelets to children with acute leukaemia. J. Paediatr., 67, 13CrossRefGoogle Scholar
  5. 5.
    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)Google Scholar
  6. 6.
    Solomon, J., Bofenkamp, T., Fahey, J. L., Chillar, R. K. and Beutler, E. (1978). Platelet prophylaxis in acute non-lymphoblastic leukaemia. Lancet, 1, 267PubMedCrossRefGoogle Scholar
  7. 7.
    Ford, J. M. and Cullen, M. H. (1977). Prophylactic granulocyte transfusions. Exp. Haematol., 5, (Suppl 1), 65Google Scholar
  8. 8.
    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, 760PubMedCrossRefGoogle Scholar
  9. 9.
    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, 219CrossRefGoogle Scholar
  10. 10.
    Schiffer, C. A., Aisner, J. and Wiernick, P. H. (1978). Frozen autologous platelet transfusion for patients with leukaemia. N. Kngl. J. Med., 299, 7CrossRefGoogle Scholar

Copyright information

© MTP Press Limited 1980

Authors and Affiliations

  • J. M. Ford

There are no affiliations available

Personalised recommendations