The 10/NL Trigger for Prophylactic Platelet Transfusion in Acute Myeloid Leukemia: A Prospective Comparative Multicenter Study

Comparison of different platelet count thresholds to guide administration of prophylactic platelet transfusion for preventing bleeding in people with haematological disorders after myelosuppressive chemotherapy or stem cell transplantation

“…Thirty-nine records were reviews (Andreu 2009; Avvisati 2003; Benjamin 2002; Blajchman 2008; Buhrkuhl 2010; Casbard 2004; Cid 2007; Dzik 2004; Goodnough 2002; Goodnough 2005; Heal 2004; Heddle 2003; Heddle 2007; Jelic 2006; Levi 2002; Lordkipanidze 2009; Lozano 2003; Martel 2004; McNicol 2003; Paramo 2004; Poon 2003; Rabinowitz 2010; Rayment 2005; Razzaghi 2012; Roberts 2003; Sakakura 2003; Shehata 2009; Shen 2007; Slichter 2004; Slichter 2007; Slichter 2012; Sosa 2003; Strauss 2004; Strauss 2005; Tinmouth 2003; Wandt 2010; Wang 2005; Woodard 2002; Zeller 2014). Twenty-six studies were not RCTs (Aderka 1986; Callow 2002; Cameron 2007; Chaoui 2005; Chaurasia 2012; Decaudin 2004; Eder 2007; Elting 2002; Elting 2003; Friedmann 2002; Gil-Fernandez 1996; Gmür 1991; Greeno 2007; Hardan 1994; Lawrence 2001; Navarro 1998; Nevo 2007; Norol 1998; Paananen 2009; Sagmeister 1999; Verma 2008; Wandt 1998; Wandt 2005; Wandt 2006; Weigand 2009; Zahur 2002). Fifty-three records were secondary citations of excluded studies (cited as secondary references for the relevant excluded studies).One study was a non-human study (Velik-Salchner 2007).…”

“…Twenty-six studies were not RCTs (Aderka 1986; Callow 2002; Cameron 2007; Chaoui 2005; Chaurasia 2012; Decaudin 2004; Eder 2007; Elting 2002; Elting 2003; Friedmann 2002; Gil-Fernandez 1996; Gmür 1991; Greeno 2007; Hardan 1994; Lawrence 2001; Navarro 1998; Nevo 2007; Norol 1998; Paananen 2009; Sagmeister 1999; Verma 2008; Wandt 1998; Wandt 2005; Wandt 2006; Weigand 2009; Zahur 2002).…”

Different doses of prophylactic platelet transfusion for preventing bleeding in people with haematological disorders after myelosuppressive chemotherapy or stem cell transplantation

“…Thirty-nine citations were reviews (including four systematic reviews) (Andreu 2009; Avvisati 2003; Benjamin 2002; Blajchman 2008; Buhrkuhl 2010; Casbard 2004; Cid 2007; Dzik 2004; Goodnough 2002; Goodnough 2005; Heal 2004; Heddle 2003; Heddle 2007; Jelic 2006; Levi 2002; Lordkipanidze 2009; Lozano 2003; Martel 2004; McNicol 2003; Paramo 2004; Poon 2003; Rabinowitz 2010; Rayment 2005; Razzaghi 2012; Roberts 2003; Sakakura 2003; Shehata 2009; Shen 2007; Slichter 2004; Slichter 2007; Slichter 2012; Sosa 2003; Strauss 2004; Strauss 2005; Tinmouth 2003; Wandt 2010; Wang 2005; Woodard 2002; Zeller 2014). Twenty-six studies were not RCTs (Aderka 1986; Callow 2002; Cameron 2007; Chaoui 2005; Chaurasia 2012; Decaudin 2004; Eder 2007; Elting 2002; Elting 2003; Friedmann 2002; Gil-Fernandez 1996; Gmur 1991; Greeno 2007; Hardan 1994; Lawrence 2001; Navarro 1998; Nevo 2007; Norol 1998; Paananen 2009; Sagmeister 1999; Verma 2008; Wandt 1998; Wandt 2005; Wandt 2006; Weigand 2009; Zahur 2002). Forty-four citations were secondary citations of excluded studies (cited as secondary references for the relevant excluded studies).In three studies fewer than 80% of the participants were haematological patients, and no data were available on the haematological subgroup (Goodnough 2001; Klumpp 1999; Lu 2011).…”

Background, rationale, and design of a clinical trial to assess the effects of platelet dose on bleeding risk in thrombocytopenic patients

“…Maintaining a higher platelet count for a greater percentage of the time with highdose platelet transfusion therapy might provide better hemostasis than low-dose therapy. However, the previously discussed prophylactic platelet transfusion trigger trials, comparing triggers of 10,000 versus 20,000 platelets/ll, demonstrated no difference in hemorrhagic morbidity or mortality between the two arms of the study [4][5][6]. Furthermore, based on radiochromium-labeled red cell stool blood loss as a measure of bleeding through an intact vascular system, stool blood loss was the same whether patients were transfused prophylactically at 5,000, 10,000, or 20,000 platelets/ll (Table IV) [23].…”

“…Three of these studies were randomized prospective platelet transfusion trials that demonstrated that a prophylactic transfusion trigger of 10,000 platelets/ll was as effective as the more standard trigger of 20,000 platelets/ll based on hemorrhagic morbidity and mortality [4][5][6]. The lower trigger significantly reduced the number of platelets transfused and, thus, the costs of platelet therapy by at least 20 to 30%.…”