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Platelet Transfusion: And Update on Challenges and Outcomes
1Blood Bank, Hematology Service, Hospital Universitari I Politècnic La Fe, Valencia, CIBERONC, Instituto Carlos III, Madrid, Spain.
Journal of Blood Medicine
|March 12, 2020
Summary
Platelet transfusions are common for cancer patients but have many unanswered questions. This review explores optimal platelet products, ABO compatibility, transfusion triggers, and refractoriness to improve clinical decisions.
Area of Science:
- Hematology
- Oncology
- Transfusion Medicine
Background:
- Platelet transfusion is a cornerstone in managing bleeding in onco-hematologic patients.
- Current guidelines exist, but significant controversies and knowledge gaps persist regarding optimal practices.
Purpose of the Study:
- To review current evidence on platelet transfusion practices in onco-hematologic patients.
- To focus on controversial issues and challenges, aiding clinical decision-making.
Main Methods:
- Literature review of scientific evidence on platelet transfusion.
- Analysis of controversial topics including product selection, ABO compatibility, and prophylactic transfusion thresholds.
Main Results:
- Uncertainty remains regarding the optimal platelet product (random vs. apheresis, plasma vs. additive solution).
- The impact of ABO-incompatible transfusions and appropriate prophylactic transfusion triggers are not well-established.
- Platelet transfusion refractoriness presents a significant challenge in management.
Conclusions:
- Despite widespread use, platelet transfusion practices in onco-hematology are fraught with unresolved issues.
- Further research is needed to address product selection, compatibility, transfusion triggers, and refractoriness.
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