Schiffer, C.A., Anderson, K.C., Bennett, C.L., Bernstein, S., Elting, L.S., Goldsmith, M., . . . & Powell, B.L. (2001). Platelet transfusion for patients with cancer: Clinical practice guidelines of the American Society of Clinical Oncology. Journal of Clinical Oncology, 19, 1519–1538.
Purpose & Patient Population
Type of Resource/Evidence-Based Process
RESOURCE TYPE: Evidence-based guideline
Phase of Care and Clinical Applications
PHASE OF CARE: Active antitumor treatment
Results Provided in the Reference
Recommends a threshold of 10,000 mcl for prophylactic platelet transfusions in patients undergoing therapy for acute leukemia. It is noted that higher levels may be necessary in newborns or patients with signs of hemorrhage and those undergoing invasive procedures. The same threshold is suggested for individuals with solid tumors, except for those receiving aggressive therapy for bladder tumors. In this case, a threshold of 20,000 mcl is recommended. It is suggested that counts of 40,000–50,000 mcl should be sufficient for major invasive procedures in the absence of coagulation abnormality. For minor procedures such as bone marrow biopsy, a platelet level of 20,000 should be adequate for safety.
Guidelines & Recommendations
The overall threshold suggested for most patient situations for prophylactic platelet transfusion is 10,000 mcl.
Limitations
In areas such as solid tumors, there is limited evidence.
Nursing Implications
This guideline provides information about administration of platelets for prevention of bleeding and recommended thresholds for prophylactic transfusions.