Platelets for neonatal transfusion - study 2: a randomised controlled trial to compare two different platelet count thresholds for prophylactic platelet transfusion to preterm neonates.
BACKGROUND
Neonatal thrombocytopenia is a common and important clinical problem in preterm neonates. A trial assessing clinically relevant outcomes in relation to the different platelet count thresholds used to trigger transfusion has never been undertaken in preterm neonates with severe thrombocytopenia.


OBJECTIVE
Platelets for Neonatal Transfusion - Study 2 (PlaNeT-2) aims to assess whether a higher prophylactic platelet transfusion threshold is superior to the lower thresholds in current standard practice in reducing the proportion of patients who have a major bleed or die up to study day 28.


METHODS
PlaNeT-2 is a two-stage, randomised, parallel-group, superiority trial. PlaNet-2 compares clinical outcomes in preterm neonates (<34 weeks' gestation at birth) randomised to receive prophylactic platelet transfusions to maintain platelet counts at or above either 25 × 10(9)/l or 50 × 10(9)/l. The primary outcome measure is the proportion of patients who either die or experience a major bleed up to and including study day 28. A total of 660 infants will be randomised.


CONCLUSIONS
This trial will help define optimal platelet transfusion support for severely thrombocytopenic preterm neonates by evaluating the risks and benefits of two different prophylactic neonatal platelet transfusion thresholds.
Cambridge University Hospitals NHS Trust, Cambridge, UK.
Anna
A
Curley
Vidheya
V
Venkatesh
Simon
S
Stanworth
Paul
P
Clarke
Timothy
T
Watts
Helen
H
New
Karen
K
Willoughby
Rizwan
R
Khan
Priya
P
Muthukumar
Alison
A
Deary
D002985:Clinical Protocols; D006470:Hemorrhage / Q000097:blood / Q000401:mortality / Q000517:prevention & control*; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D007234:Infant, Premature; D010976:Platelet Count; D017713:Platelet Transfusion / Q000009:adverse effects / Q000379:methods*; D011237:Predictive Value of Tests; D012107:Research Design; D054098:Thrombocytopenia, Neonatal Alloimmune / Q000097:blood / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D006113:United Kingdom