Platelet transfusion in thrombocytopenic cancer patients: Sometimes justified but likely insidious

The transfusion of platelet concentrates prepared from allogeneic single or pooled donations is a standard procedure in transfusion medicine to stop or prevent bleeding in cancer patients with thrombocytopenia undergoing surgery, chemotherapy and/or radiotherapy. While platelet transfusion may appear reasonable in many instances, greater scientific and medical attention should however be given to the possibly insidious impact of transfused platelets on the outcome of cancers. Indeed platelets and the microvesicles they release possess all the biological ingredients capable of supporting tumor growth, protecting circulating tumor cells, and to contributing to metastatic invasion. Until any randomized controlled trials can objectively document their effects on survival or cancer recurrence, minimizing the use of platelet transfusion in cancer patients appears to represent a reasonable precautionary measure.