Prevalence and Predictors of Platelet Refractoriness

Platelet transfusion is one of the main treatments for thrombocytopenia to reduce severity and frequency of bleeding. Inadequate increase in platelets following platelet transfusion is known as platelet refractoriness. The aim of this study is to investigate the prevalence, as well as predictive factors, of platelet refractoriness.

In a cross sectional study, 73 patients suffering from severe thrombocytopenia due to leukemia or aplastic anemia, hospitalized at the hematology-oncology ward of two main referral hospitals in Mashhad, were evaluated. Platelet transfusion was done in patients with platelets count less than 10,000 per microliter or less than 20,000 per microliter and fever more than 38° C. Platelet count was measured before and 60 minutes after platelet transfusion, and after calculating body surface area (m2), corrected count increment (CCI) was calculated. If CCI is more than 10,000 per microliter, no platelet refractoriness was considered.

55 patients (75.3%) had platelet refractoriness. Higher platelet refractoriness was seen in the group that received more platelet units and patients who received apheresis units had less refractoriness.

Platelet transfusion should be done only if necessary and transfusion of apheresis units must be considered in patients who need regular platelet transfusion.