The efficacy of platelet transfusion in the management of ITP remains obscure. In patients with hematologic disorders undergoing myelosuppressive chemotherapy or hematopoietic stem cell transplantation, platelets are widely transfused prophylactically, and a platelet transfusion threshold of 10,000/μL has been recommended to be safe and effective. In ITP, however, prophylactic platelet transfusion is not recommended because the rise in platelet counts following platelet transfusion is not seen because of rapid destruction of transfused platelets. In ITP patients with severe active bleeding, anecdotal evidence suggests successful treatment of platelet transfusion alone or in combination with intravenous immunoglobulin. Platelet transfusion may be also considered before splenectomy in ITP patients. Recent studies suggest that laparoscopic splenectomy can be a safe and feasible procedure in ITP patients with platelet count less than 10 × 103/μL without platelet transfusion.
KeywordsPlatelet Count Acute Myeloid Leukemia Hematopoietic Stem Cell Transplantation Bleeding Risk Platelet Transfusion
- 7.Diedrich B, Remberger M, Shanwell A, et al. A prospective randomized trial of a prophylactic platelet transfusion trigger of 10 × 10(9) per L versus 30 × 10(9) per L in allogeneic hematopoietic progenitor cell transplant recipients. Transfusion. 2005;45:1064–72.Google Scholar
- 12.Estcourt LJ, Stanworth SJ, Doree C, et al. Comparison of different platelet count thresholds to guide administration of prophylactic platelet transfusion for preventing bleeding in people with haematological disorders after myelosuppressive chemotherapy or stem cell transplantation. Cochrane Database Syst Rev. 2015;11:CD010983.PubMedCentralGoogle Scholar
- 18.Nevo S, Fuller AK, Hartley E, et al. Acute bleeding complications in patients after hematopoietic stem cell transplantation with prophylactic platelet transfusion triggers of 10 × 10(9) and 20 × 10(9) per L. Transfusion. 2007;47:801–12.Google Scholar
- 21.Eugster M, Reinhart WH. The influence of the haematocrit on primary haemostasis in vitro. Thromb Haemost. 2005;94:1213–8.Google Scholar