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Prophylactic platelet transfusion threshold during therapy for adult acute myeloid leukemia: 10,000/muL versus 20,000/muL


, : Prophylactic platelet transfusion threshold during therapy for adult acute myeloid leukemia: 10,000/muL versus 20,000/muL. Haematologica 83(11): 998-1000, Nov

Background and Objective. The threshold for prophylactic platelet transfusions has been classically established at 20,000/muL. 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/muL (group A) to 10,000/muL (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. Between January 1989 and December 1993 the patients received prophylactic platelet transfusions when their platelet count was below 20,000/muL (group A), and from January 1994 to March 1998 prophylactic platelet transfusions were indicated below 10,000/muL or between 10,000/muL and 20,000/muL 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 340A fewer transfusions during Induction and 15.5% fewer during consolidation (p=0.04). There were no differences between groups regarding major bleeding episodes. Interpretation and Conclusions. Our data show that the threshold for prophylactic platelet transfusion can be safely set at 1.0,000 muL during Induction and consolidation chemotherapy for adult patients with de novo AML.

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