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Platelet Transfusions Prevent Bleeding in Hematologic Cancers

According to an article recently published in the New England Journal of Medicine, transfusions with platelets can significantly prevent bleeding in patients with hematologic (blood) cancers.

Platelets are components of the blood that are responsible for the clotting of blood. Low levels of platelets is referred to as thrombocytopenia. Patients with hematologic cancers are susceptible to thrombocytopenia, particularly when undergoing treatment for their disease. Thrombocytopenia is associated with bleeding that is not able to be controlled. Ultimately, uncontrolled bleeding can result in death.

Researchers from the United Kingdom and Australia recently conducted a clinical trial to evaluate the effects of platelet transfusions for patients with hematologic cancers. The trial included 600 patients, all of whom were undergoing chemotherapy or a stem cell transplant. Approximately half (299) received prophylactic platelet transfusions and 301 did not receive prophylactic platelet transfusions.

Moderate to severe bleeding occurred in 50% of the patients who did not receive prophylactic platelet transfusions, compared with 43% of those who did receive the transfusions.
Patients who did not receive the prophylactic transfusions had significantly more days of bleeding and a shorter time to the first bleeding episode compared with patients who did receive the transfusions.
There was no significant difference in bleeding rates between those receiving prophylactic platelet transfusions and those not receiving the prophylactic transfusions among the patients who were undergoing an autologous stem-cell transplant.
The researchers concluded that ” The results of our study support the need for the continued use of prophylaxis with platelet transfusion and show the benefit of such prophylaxis for reducing bleeding, as compared with no prophylaxis. A significant number of patients had bleeding despite prophylaxis.”

Reference: Stanworth S, Estcourt L, Powter G, et al. A No-Prophylaxis Platelet-Transfusion Strategy for Hematologic Cancers. New England Journal of Medicine. 2013; 368:1771-1780.