Seuils transfussionnels plaquettaires en onco-hématologie

Details

Supervisors

Gothot, André

Faculty

Faculté de médecine et médecine dentaire

Degree label

Mémoire en médecine transfusionnelle

Abstract

Goal : Analyze the various randomized controlled trials and recent reviews based on platelet transfusion therapy in adult and pediatric patients with central thrombocytopenia secondary to chemotherapy or hematopoietic stem cell transplantation. Method: This is a retrospective study based on the research of the literature. The publications were journals, theses and articles by various authors. The materials were published in English from 2012 to 2015.The research was carried out on the basis of the computer data available on Pubmed. Results : It is recommended that prophylactic platelet transfusions be administered to adult non-hemorrhagic and pediatric patients with central thrombocytopenia using a platelet count threshold of 10.000/ ml. The transfusions of platelets at low or standard dose (1.1 x 10 11/m2 or 2.2 x 10 11/ m2, respectively) should be used in hospitalized patients. Pathogen-reduced platelets appear to be an acceptable alternative to standard platelets due to their reduced risk of infectious complications and their comparable efficacy to minimize clinically significant bleeding. Adjuvant treatments for prophylactic platelet transfusions, such as anti-fibrinolytics and rhTPO /TPO agonists, may have a beneficial effect in improving bleeding results in patients with central thrombocytopenia, particularly those with PTR. Future treatments may include laboratory-grown platelets and artificial platelet substitutes if they are found to be safe and effective in humans, and would be favorable to compensate for the know, disadvantages of standard platelet concentrates used in transfusions for patients suffering of thrombocytopenia.