Should Prophylactic Platelets be given to Patients with Acute Leukaemia?
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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 The three clinical trials which bear on this subject will be discussed together with some (as yet) unpublished data from this centre.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.
KeywordsPlatelet Count Acute Leukaemia Platelet Transfusion Contentious Debate Central Nervous System Bleeding
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