Prophylactic platelet transfusion threshold during therapy for adult acutemyeloid leukemia: 10,000/mu L versus 20,000/mu l

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.