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Novel Therapeutic Approaches May Transform Treatment and Improve Patient Outcomes in Several Platelet Disorders
Date:12/6/2008

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Effects of Prophylactic Platelet Dose on Transfusion Outcomes(PLADOTrial) [Abstract #285]

Sherrill J. Slichter, MD, Puget Sound Blood Center forthe National Heart, Lung, and BloodInstitute TransfusionMedicine/HemostasisClinical Trials Network, Seattle, WA

This study, the first large-scale clinical trial to compare the effects of different platelet-transfusion dosing regimens on hemostatic outcomes in patients with hypoproliferative thrombocytopenia, found that patients can be safely and effectively transfused with a low dose of platelets, a strategy that can reduce costs and help prevent shortages in the blood supply.

A total of 1,272 patients with hypoproliferative thrombocytopenia (which is caused by failure of the marrow to produce platelets) who were expected to be hospitalized with platelet counts of less than or equal to 10,000 microliters for more than five days were enrolled in the study and received at least one platelet transfusion. Patients were randomized to receive one of three platelet-transfusion dosing regimens: a low dose (1.1 x 10^11 platelets/m^2), a medium dose (2.2 x 10^11 platelets/m^2), or a high dose (4.4 x 10 ^11 platelets/m^2). An acceptable dose of platelets could be within 25 percent (lower or higher) of the target dose. Patients were stratified into four groups based on the cause of thrombocytopenia: those who had received chemotherapy for a hematologic malignancy (313 patients), chemotherapy for a solid tumor (seven patients), autologous stem cell transplant (429 patients), or an allogeneic stem cell transplant (523 patients). Patients were prophylactically transfused on days when platelet counts were less than or equal to 10,000 microliters.

The primary endpoint of the
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SOURCE American Society of Hematology
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