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- W144581693 abstract "To the Editor: We recently reported on a trial1 that was similar to the Trial of Prophylactic Platelets (TOPPS) by Stanworth et al. (May 9 issue).2 TOPPS showed that a strategy of prophylactic platelet transfusion, as compared with a strategy of no prophylaxis, was marginally superior in preventing bleeding of World Health Organization (WHO) grade 2 or higher in patients with hematologic cancers. This superiority was observed primarily in patients with leukemia. In patients undergoing autologous transplantation, the two strategies were equally effective. Many bleeding episodes of WHO grade 2 are not a relevant clinical problem. Among patients undergoing autologous transplantation, we observed virtually no severe bleeding with the noprophylaxis strategy. In accordance with TOPPS, we observed severe bleeding primarily in patients with leukemia. Post hoc analysis of 443 induction and consolidation cycles showed significantly more bleeding during induction. We think that the transfusion strategy should be adjusted to different hematologic cancers and treatments. In our experience, there is no strategy that fits all. In conclusion, in 453 autologous transplantations, a no-prophylaxis strategy was safe.1-3 The number of platelet transfusions was reduced significantly when prophylactic transfusion was omitted.1,2 Transfusions are not benign.4 We therefore do not agree with the conclusion of Slichter’s editorial regarding TOPPS.5 In adult patients with low bleeding risk (e.g., those undergoing autologous transplantation), it is now time to rethink prophylactic platelet transfusion." @default.
- W144581693 created "2016-06-24" @default.
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- W144581693 date "2013-08-08" @default.
- W144581693 modified "2023-09-27" @default.
- W144581693 title "Prophylactic Platelet Transfusion" @default.
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- W144581693 doi "https://doi.org/10.1056/nejmc1307163" @default.
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