|
| Study | Type | Population | Method | Prevalence | Clinical outcomes |
|
| Legler et al., 1997 [4] | Prospective cohort | 145 patients with hemato-oncological disease at a single center, who received at least two platelet transfusions | Platelet counts repeatedly after ≥two successive platelet transfusions within 48 hours < 20000 × 106/L (16-hr count) or <10000 × 106/L (24-hr count) | 27.6% | Not assessed |
|
| TRAP study, 1997 [5] | Randomized clinical trial | 530 patients receiving induction chemotherapy for acute myeloid leukemia | CCI <5000 after two sequential transfusions | 10% | No comparison between refractory and nonrefractory patients reported |
|
| Meehan et al., 2000 [6] | Prospective cohort | 292 consecutive patients at a single hospital who received platelet transfusions over a six-month period | Three consecutive days of platelet transfusions produced posttransfusion platelet count increments (corrected or uncorrected) ≤ 5000 × 106/L | 21.6% | Among refractory patients (compared to nonrefractory) |
| | (i) Increased mean platelet use (units): 20.6 vs. 2.8, < 0.0001 |
| | (ii) Increased mean hospitalization costs (US $): 103,956 vs. 36,818, < 0.0001 |
| | (iii) Increased mean length of stay: 35.0 vs. 14.4 days, < 0.0001 |
|
| Slichter et al., 2005 [7] | Ad hoc analysis of a randomized clinical trial | 533 patients receiving induction chemotherapy for acute myeloid leukemia | 2 sequential 1-hour posttransfusion platelet increments of less than 11000 × 106/L | 27% | Not assessed |
|
| Kerkhoffs et al., 2008 [8] | Ad hoc analysis of a randomized clinical trial | 117 patients hospitalized in the hematology ward who needed or were expected to need 2 or more platelet transfusions | 1-hour CCI <7500 and/or a 24-hour CCI <4500 | 49.6% | Among refractory (compared to nonrefractory patients) |
| (i) Decreased 100-day survival (83% vs. 98%, < 0.01) |
| (ii) Decreased median survival (491.0 days (Q1, Q3: 156.0, 858.0) vs. 825 days (Q1, Q3: 355.0, 996.0), = 0.032) |
| (iii) Increased risk of bleeding: odds ratio: 3.4; 95% CI: 1.1–11 |
|
| Ferreira et al., 2011 [9] | Prospective cohort | 16 adult oncology/hematology patients | Two successive transfusions with CCI <5000 | 19% (3 patients) | Not assessed |
|
| Hess et al., 2016 [10] | Secondary analysis of a randomized clinical trial | 734 hematology-oncology patients receiving at least 2 platelet transfusions | Two consecutive CCIs of ≤5000 | 14% | Not assessed |
|
| Comont et al., 2017 [11] | Retrospective cohort | 897 adult patients with acute myeloid leukemia receiving intensive chemotherapy | Persistent thrombocytopenia <10000 × 106/L despite at least two successive daily platelet transfusions | 4.8% | Among patient with refractoriness (compared to those without) |
| (i) Increased severe bleeding events (22% vs. 4.1%, < 0.0001) |
| (ii) Increased early death caused by bleeding (12.2% vs. 1.4%, = 0.0006) |
| (iii) Increased death by bleeding at any time (24.4% vs. 5.3%, < 0.0001) |
|
