Extended Small-Dose Platelet Transfusions in Multitransfused Hemato-Oncological Patients: A Single-Center Experience.
BACKGROUND
Refractoriness to platelet transfusion, prevalent among 15-20% of hemato-oncological patients, is associated with multitransfusions and inferior outcomes. We evaluated the effectiveness of extended slow-dose transfusion (ESDT) in increasing platelet increments in multitransfused patients.


METHODS
Patients treated after the implementation of ESDT were compared with historical controls treated with standard single-donor platelet (SDP) transfusions. Cohorts of early and late recipients were assembled for comparison, i.e. the 8th or 9th and 11th platelet unit per patient, respectively. Patients in the ESDT group received transfusions equal to half an SDP unit, administered over 4 h. Effectiveness was defined as a higher corrected count increment (CCI) at 1, 12, and 24 h after transfusion.


RESULTS
In the early-recipients cohort, 24-h-posttransfusion increments were available for 29 ESDT patients and 6 standard patients, and did not differ significantly between the groups (p = 0.078). The 24-h-posttransfusion increment was available for 20 ESDT patients and 7 standard patients in the late-recipients cohort. The CCI was significantly higher in the ESDT group (p = 0.042). ABO compatibility improved the CCI (p = 0.01).


CONCLUSIONS
ESDT demonstrated slightly higher increments at 24 h after transfusion in late recipients, suggesting this could be a cost-effective approach for the treatment of thrombocytopenic multitransfused hemato-oncological patients.
['Gurevich-Shapiro|Anna|A|', 'Tzadok|Sharon|S|', 'Rosenberg|Alina|A|', 'Inbal|Aida|A|', 'Bar-Natan|Michal|M|', 'Wolach|Ofir|O|', 'Raanani|Pia|P|']
D000328:Adult D000368:Aged D015331:Cohort Studies D005260:Female D019337:Hematologic Neoplasms D006801:Humans D007938:Leukemia D008223:Lymphoma D008297:Male D008875:Middle Aged D010976:Platelet Count D017713:Platelet Transfusion D012307:Risk Factors D013921:Thrombocytopenia D013997:Time Factors D016896:Treatment Outcome D055815:Young Adult
Platelet transfusion Hematology/oncology Platelet refractoriness Supportive care Thrombocytopenia