Outpatient Platelet Transfusions in Myelodysplastic Syndromes and Leukemia: The OPTIMAL Pilot
As a result of the underlying disease or its therapy, it is common for patients with blood
cancers to have low platelet counts. While platelet transfusions may be beneficial in
preventing or treating bleeding symptoms, in circumstances where the risk of bleeding is low
they may be unnecessary or even harmful. As a blood product, transfusion of platelets may be
associated with infectious or allergic complications, and frequent hospital visits for
transfusion may adversely affect quality of life. Additionally, the potentially overuse of
platelet products places a burden on health care resources.
The benefit of the current practice of prophylactic platelet transfusions to prevent
hemorrhage is unknown. The randomized data that exists is more than 25 years old and not
informative given methodological limitations and the changing standards of supportive care.
An alternative, therapeutic, strategy involves only administering platelets to control
The standard of practice in inpatients receiving high dose chemotherapy (either for acute
leukemia or as part of stem cell transplantation) is prophylactic platelet transfusions. In
outpatients not receiving high dose chemotherapy, the risk of bleeding is significantly
lower. No randomized trials have examined the optimal platelet transfusion strategy in
outpatients with blood cancers undergoing supportive or palliative therapy. Thus the
potential benefit of prophylactic transfusions in the outpatient setting is unknown.
The investigators propose to perform a pilot randomized controlled trial to determine if a
larger trial is possible. The ultimate goal is to determine if a strategy of therapeutic
platelet transfusions is safe and effective in outpatients with blood cancers and low
View this trial on ClinicalTrials.gov
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These resources are provided in partnership with the
Canadian Cancer Society