ASCO Clinical Practice Guideline Update: Platelet Transfusion for Patients With Cancer

As reported in the Journal of Clinical Oncology by Charles A. Schiffer, MD, of Karmanos Cancer Institute, Wayne State University School of Medicine, and colleagues, ASCO has issued a clinical practice guideline update on platelet transfusions in patients with cancer.

The updated guideline replaces the former guideline, initially issued in 2001. The updated guideline is informed by an ASCO expert panel systematic review of literature published from September 2014 through October 2016, two 2015 systematic reviews conducted by the AABB (formerly, the American Association of Blood Banks) and the International Collaboration for Transfusion Medicine Guidelines, and an ASCO literature search back to 2000 for issues not covered in the 2015 reviews. Overall, the updated ASCO review included 24 more recent publications, including 3 clinical practice guidelines, 8 systematic reviews, and 13 observational studies. The expert panel was co-chaired by Dr. Schiffer and Kenneth C. Anderson, MD, of Dana-Farber Cancer Institute, Harvard Medical School.

Key elements of the updated recommendations are summarized here.

Key Elements of Updated Recommendations

  • The most substantial change to a previous recommendation involves platelet transfusion in patients undergoing hematopoietic stem cell transplantation. Based on data from randomized controlled trials, adult patients who undergo autologous stem cell transplantation at experienced centers may receive a platelet transfusion at the first sign of bleeding, rather than prophylactically.
  • Prophylactic platelet transfusion at defined platelet count thresholds is still recommended for pediatric patients undergoing autologous stem cell transplantation and for adult and pediatric patients undergoing allogeneic stem cell transplantation.
  • Other recommendations address platelet transfusion in patients with hematologic malignancies or solid tumors or in those who undergo invasive procedures.
  • Guidance is also provided regarding the production of platelet products, prevention of Rh alloimmunization, and management of refractoriness to platelet transfusion.

Further information is available at www.asco.org/supportivecare-guidelines and http://www.asco.org/guidelineswiki.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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