Prophylactic platelet transfusion threshold during therapy for adult acute myeloid leukemia: 10,000/microL versus 20,000/microL.
OBJECTIVE
The threshold for prophylactic platelet transfusions has been classically established at 20,000/microL. 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/microL (group A) to 10,000/microL (group B) after induction and consolidation chemotherapy.


METHODS
Forty-eight adult patients with de novo AML diagnosed in a single institution in a nine year period were enrolled in the study. Between January 1989 and December 1993 the patients received prophylactic platelet transfusions when their platelet count was below 20,000/microL (group A), and from January 1994 to March 1998 prophylactic platelet transfusions were indicated below 10,000/microL or between 10,000/microL and 20,000/microL if there was any consumption factor.


RESULTS
The mean number (SD) of platelet transfusions during induction was 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% fewer transfusions during induction and 15.5% fewer during consolidation (p = 0.04). There were no differences between groups regarding major bleeding episodes.


CONCLUSIONS
Our data show that the threshold for prophylactic platelet transfusion can be safely set at 10,000 microL during induction and consolidation chemotherapy for adult patients with de novo AML.
Navarro
J T
JT
Hematology-Hemotherapy Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
Hernández
J A
JA
Ribera
J M
JM
Sancho
J M
JM
Oriol
A
A
Pujol
M
M
Millá
F
F
Feliu
E
E
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000677:Amsacrine / Q000008:administration & dosage / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D003561:Cytarabine / Q000008:administration & dosage / Q000009:adverse effects; D003630:Daunorubicin / Q000008:administration & dosage / Q000009:adverse effects; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D006470:Hemorrhage / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D015255:Idarubicin / Q000008:administration & dosage / Q000009:adverse effects; D007951:Leukemia, Myeloid / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage / Q000009:adverse effects; D010198:Pancytopenia / Q000139:chemically induced; D010976:Platelet Count; D017713:Platelet Transfusion / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D013921:Thrombocytopenia / Q000139:chemically induced / Q000628:therapy*
D000677:Amsacrine; D003561:Cytarabine; D005047:Etoposide; D008942:Mitoxantrone; D015255:Idarubicin; D003630:Daunorubicin