1. Platelet transfusions and predictors of bleeding in patients with myelodysplastic syndromes.
- Author
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Mo A, Wood E, Shortt J, Hu E, and McQuilten Z
- Subjects
- Humans, Male, Adolescent, Adult, Aged, Female, Platelet Transfusion adverse effects, Retrospective Studies, Australia epidemiology, Hemorrhage diagnosis, Hemorrhage etiology, Hemorrhage therapy, Myelodysplastic Syndromes complications, Myelodysplastic Syndromes diagnosis, Myelodysplastic Syndromes therapy, Thrombocytopenia complications, Thrombocytopenia diagnosis, Tranexamic Acid therapeutic use
- Abstract
Objectives: This study aimed to describe the burden of thrombocytopenia, supportive care practices, bleeding complications and predictors of bleeding in MDS patients within a large Australian hospital network, to better understand the use and effectiveness of platelet transfusions in MDS., Methods: A retrospective cohort study of patients aged ≥18 years with MDS, chronic myelomonocytic leukaemia or MDS/myeloproliferative overlap neoplasm admitted from 2016 to 2018 was conducted. Data were obtained from hospital medical records., Results: One hundred seventy-nine patients (median age 78 years, 61.5% male) were identified. The median platelet count at first admission was 90 × 10
9 /L. Twenty-eight (15.6%) patients had severe thrombocytopenia (platelet count <20 × 109 /L), of whom nine (32.1%) received prophylactic platelet transfusions, five (17.9%) received tranexamic acid (TXA), seven (25%) received both platelet transfusions and TXA, and seven (25%) received no treatment. Bleeding events requiring hospitalisation occurred in 20 (11.2%) patients. Bleeding was not predicted by presenting platelet count, TXA use, platelet transfusion or anticoagulant/antiplatelet therapies. Three patients died of bleeding, at varying platelet counts (18, 38 and 153 × 109 /L)., Conclusion: Thrombocytopenia is common in MDS. Although guidelines recommend otherwise, prophylactic platelet transfusions were commonly used for severe thrombocytopenia. Despite the majority of patients receiving platelet transfusions and/or TXA, 11% developed major bleeding occurring at a wide range of platelet counts., (© 2023 The Authors. European Journal of Haematology published by John Wiley & Sons Ltd.)- Published
- 2023
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