Document Detail


A descriptive analysis of international transfusion practice and bleeding outcomes in patients with acute leukemia.
MedLine Citation:
PMID:  16734806     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Recently, bleeding has been used in platelet (PLT) trials rather than surrogate outcomes. The purpose of this study was to provide a descriptive summary of data from PLT studies conducted in four countries and exploratory analyses to determine the relationship between bleeding and PLT count. STUDY DESIGN AND METHODS: A descriptive analysis was performed on original data from the Italian trigger study, the US TRAP study, the Canadian febrile reaction study, and a clinical chart review from one hospital site in the United Kingdom. The relationship between bleeding and PLT count was explored with the Italian data. RESULTS: A total of 897 patients with acute leukemia received 10,506 PLT transfusions. Grade 3 or Grade 4 WHO bleeding frequency was 28.1 percent (252/897) but varied by country: Italy, 10.8 percent (27/250); United States, 36.4 percent (217/598); Canada, 18.9 percent (7/37); and the United Kingdom, 8.3 percent (1/12). Grade 1 or Grade 2 bleeding was reported only in the Italian study (46.4%[116/250] and 11.6%[29/250], respectively). The relative rates of WHO Grade 2, 3, or 4 bleeding for PLT counts in the ranges of 0 to 4, 5 to 9, 10 to 14, and 15 to 19 (x10(9)/L) were 8.8, 1.9, 1.8, and 1.2, respectively, compared to those counts within the range of 20 to 29 (x10(9)/L). CONCLUSION: The study provides descriptive data on PLT use and frequency of bleeding. When PLT counts were 0x10(9) to 4x10(9) per L there was an eightfold increase in bleeding and a twofold risk increase when counts were 5x10(9) to 14x10(9) per L compared to the 20x10(9) to 29x10(9) per L reference range. The increased rate of bleeding at low counts occurred despite PLT therapy.
Authors:
Nancy M Heddle; Richard J Cook; Chris Sigouin; Sherrill J Slichter; Mike Murphy; Paolo Rebulla;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Transfusion     Volume:  46     ISSN:  0041-1132     ISO Abbreviation:  Transfusion     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-05-31     Completed Date:  2006-07-18     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0417360     Medline TA:  Transfusion     Country:  United States    
Other Details:
Languages:  eng     Pagination:  903-11     Citation Subset:  IM    
Affiliation:
Department of Medicine, McMaster University, Canadian Blood Services, Hamilton, Ontario, Canada, and the Transfusion and Transplant Immunology Center IRCCS, Maggiore Hospital, Milan, Italy. heddlen@mcmaster.ca
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Canada
Data Collection
Great Britain
Hemorrhage / prevention & control*,  therapy
Humans
Incidence
Italy
Leukemia / complications*,  therapy*
Platelet Count
Platelet Transfusion*
Randomized Controlled Trials as Topic
Retrospective Studies
United States

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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