PROPHYLACTIC VERSUS THERAPEUTIC PLATELET TRANSFUSION PRACTICES IN HEMATOLOGY AND OR ONCOLOGY PATIENTS/

Background: Platelet utilization has steadily increased throughout the past three decades. At the same time, there has been very little stud y of the current transfusion practices. Study Design and Methods: A su rvey was conducted of institutional members of the American Associatio n of Blood Banks (hospitals) that were actively involved in the care o f pediatric and/or adult hematology and/or oncology patients, Inquirie s were made relating to the extent of prophylactic versus therapeutic use of platelets, criteria used for prophylactic transfusion of platel ets and type, and dose of platelets used, Data were analyzed according to patient age and type of hospital. Results: Of 786 responding hospi tals, 630 (80.2%) provided sufficient data for analysis; 126 of that 6 30 provided care for pediatric patients, The majority (60.9%) of respo nding hospitals had a minimum of four hematologists and/or oncologists , Eighty-four percent of hospitals reported transfusing some apheresis platelets, The dose of platelet concentrates most frequently used for adults ranged from 6 to 10, with pools of 10 more commonly used in co mmunity hospitals, More than 70 percent of hospitals reported transfus ing platelets primarily for prophylaxis: 60 percent of hospitals set t he threshold platelet count for prophylactic platelet transfusion at 2 0,000 per mu L, with approximately 20 percent each transfusing at high er and lower levels. A platelet count of 50,000 per mu L was most freq uently required for performance of a minor invasive procedure. Conclus ion: The data from this study show that the majority of institutions u se prophylactic platelet transfusion in both pediatric and adult hemat ology and/or oncology patients. However, there is considerable variati on in platelet transfusion practice.