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Titolo:
Lowering the prophylactic platelet transfusion threshold: A prospective analysis
Autore:
Lawrence, JB; Yomtovian, RA; Hammons, T; Masarik, SR; Chongkolwatana, V; Creger, RJ; Manka, A; Lazarus, HM;
Indirizzi:
Univ Hosp Cleveland, Cleveland, OH 44106 USA Univ Hosp Cleveland Cleveland OH USA 44106 eland, Cleveland, OH 44106 USA
Titolo Testata:
LEUKEMIA & LYMPHOMA
fascicolo: 1-2, volume: 41, anno: 2001,
pagine: 67 - 76
SICI:
1042-8194(200103)41:1-2<67:LTPPTT>2.0.ZU;2-A
Fonte:
ISI
Lingua:
ENG
Soggetto:
ACUTE MYELOID-LEUKEMIA; AMPHOTERICIN-B; APLASTIC-ANEMIA; THERAPY; POLICY; 20,000/MU-L; THROMBOCYTOPENIA; TRANSPLANTATION; CONTROVERSIES; 10,000/MU-L;
Keywords:
platelet transfusion; hemorrhage; thrombocytopenia; leukemia; blood & marrow transplant;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
48
Recensione:
Indirizzi per estratti:
Indirizzo: Lazarus, HM Univ Hosp Cleveland, 11000 Euclid Ave, Cleveland, OH 44106 USAUniv Hosp Cleveland 11000 Euclid Ave Cleveland OH USA 44106 SA
Citazione:
J.B. Lawrence et al., "Lowering the prophylactic platelet transfusion threshold: A prospective analysis", LEUK LYMPH, 41(1-2), 2001, pp. 67-76

Abstract

The 20 x 10(9)/L threshold for prophylactic platelet transfusion may be unnecessarily high. Few prospective studies. however, in which other trigger values were tested have been published. In this study all hospitalized, thrombocytopenic adult hematology-oncology patients in our institution were prospectively evaluated daily for hemorrhage and platelet transfusion during a one year period; no patients were excluded for bleeding or infectious problems. By design, during the initial six-months: (baseline period), the prophylactic platelet transfusion trigger was 20 x 10(9)/L; for the second six-months (study period) this threshold was changed to 10 x 10(9)/L. Patientsstudied during the two periods did not differ significantly in age, gender. diagnosis. blood or marrow transplant status, and duration of neutropenia. Compliance with the thresholds was 95.6% (baseline period) and 93.5% (study period). For patients with platelet counts under 20 x 10(9)/L. the mean use of platelet transfusions per patient per day was significantly lower inthe study period (4.47) than in the baseline period (6.48: p<0.001). Both mean prophylactic (1.54/patient-day) and therapeutic (2.93/patient-day) platelet transfusions were reduced in the study period compared with the baseline period (2.16 and 4.22/patient-day, respectively). Hemorrhage was slightly reduced in the study period compared with the baseline period: major hemorrhage, 15.2% vs. 18.4% (p=0.014): minor hemorrhage. 63.6% vs. 70.1% (p<0.001). Thus, hemorrhage was not increased with the lower trigger level. A 10x 10(9)/L prophylactic platelet transfusion threshold value is safe and effective.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 09/04/20 alle ore 17:44:06