Jt. Navarro et al., Prophylactic platelet transfusion threshold during therapy for adult acutemyeloid leukemia: 10,000/mu L versus 20,000/mu l, HAEMATOLOG, 83(11), 1998, pp. 998-1000
Background and Objective. The threshold for prophylactic platelet transfusi
ons has been classically established at 20,000/mu L. In 48 patients with de
novo acute myeloblastic leukemia (AML) we analyzed the effect of reducing
the threshold for prophylactic platelet transfusion From 20,000/mu L (group
A) to 10,000/mu L (group B) after induction and consolidation chemotherapy
.
Design and Methods. Forty-eight adult patients with de novo AML, diagnosed
in a single institution in a nine year period were enrolled In the study. B
etween January 1989 and December 1993 the patients received prophylactic pl
atelet transfusions when their platelet count was below 20,000/mu L (group
A), and from January 1994 to March 1998 prophylactic platelet transfusions
were Indicated below 10,000/mu L or between 10,000/mu L and 20,000/mu L If
there was any consumption factor.
Results. The mean number (SD) of platelet transfusions during: induction wa
s 8.4 (5.3) in group A and 8.5 (5.5) In group B; and during consolidation 4
.7 (3.4) in group A and 4.6 (3.8) in group B (p=n.s.). Excluding the cases
with consumption factors from the analysis, group B patients required 34% f
ewer transfusions during induction and 15.5% fewer during consolidation (p=
0.04). There were no differences between groups regarding major bleeding ep
isodes.
Interpretation and Conclusions. Our data show that the threshold far prophy
lactic platelet transfusion can be safely set at 10,000 mu L during inducti
on and consolidation chemotherapy for adult patients with de novo AML. (C)1
998, Ferrata Storti Foundation.