Risk of bleeding and use of platelet transfusions in patients with hematologic malignancies: recurrent event analysis

Haematologica
Simon J StanworthTOPPS Study Investigators

Abstract

A recent randomized trial (TOPPS) compared prophylactic platelet transfusions (for counts <10×10(9)/L) with a strategy of no-prophylaxis in adults with hematologic malignancies. Seventy percent of enrolled patients received an autologous hematopoietic stem cell transplant. Statistical models were developed to explore which patient factors or clinical characteristics are important prognostic factors for bleeding. These models were presented for baseline characteristics and for recurrent analysis of bleeding to assess the risks of World Health Organization grade 2-4 bleeding on any given day. Additional analyses explored the importance of fever. Treatment plan (chemotherapy/allogeneic hematopoietic stem cell transplant), female sex, and treatment arm (no-prophylaxis) were significantly associated with an increased number of days of bleeding. The number of days with a platelet count <10×109/L was significantly associated with a grade 2-4 bleed (P<0.0001). Patients with a temperature of at least 38°C had the highest hazard of a grade 2-4 bleed (hazard ratio: 1.7, 95% confidence interval: 1.3 to 2.4, compared with the risk in patients with a temperature <37.5°C). There was no evidence that minor bleeding predicted a grade 2-4 bleed....Continue Reading

Citations

Apr 27, 2016·Hematology/oncology Clinics of North America·Gemma L CrightonSimon J Stanworth
Oct 28, 2016·British Journal of Haematology·Michael J R DesboroughSimon J Stanworth
Dec 23, 2016·British Journal of Haematology·Lise J EstcourtUNKNOWN British Committee for Standards in Haematology
Nov 10, 2018·Hospital Practice·Stamatis J KarakatsanisKonstantinos N Syrigos
Sep 9, 2017·Blood·Jeffrey L Carson, Simon J Stanworth
Aug 15, 2017·Current Opinion in Hematology·Jingcheng ZhaoSimon J Stanworth
Oct 5, 2018·American Journal of Clinical Pathology·Amy E SchmidtMyra Coppage
Feb 6, 2019·Internal Medicine Journal·Emma LeitingerAndrew Grigg
Feb 23, 2021·Transfusion·Khai Li Chai, Erica M Wood
Apr 4, 2021·Journal of Clinical Medicine·Avi LeaderGalia Spectre
Aug 17, 2021·Platelets·Peter Smethurst, Rebecca Cardigan

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