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Title: | Platelet transfusions and predictors of bleeding in patients with myelodysplastic syndromes. | Austin Authors: | Mo, Allison ;Wood, Erica;Shortt, Jake;Hu, Erin;McQuilten, Zoe | Affiliation: | Transfusion Research Unit, School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia. Monash Haematology, Monash Health, Melbourne, Victoria, Australia. School of Clinical Sciences, Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, Victoria, Australia. Pharmacy Department, Monash Health, Melbourne, Victoria, Australia. Transfusion Research Unit, School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia.;Monash Haematology, Monash Health, Melbourne, Victoria, Australia. Pathology Laboratory Haematology |
Issue Date: | Oct-2023 | Date: | 2023 | Publication information: | European Journal of Haematology 2023-10; 111(4) | Abstract: | 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. 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. One hundred seventy-nine patients (median age 78 years, 61.5% male) were identified. The median platelet count at first admission was 90 × 109 /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). 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. | URI: | https://ahro.austin.org.au/austinjspui/handle/1/33331 | DOI: | 10.1111/ejh.14049 | ORCID: | 0000-0002-1923-3133 0000-0003-3185-6488 0000-0001-9698-7185 |
Journal: | European Journal of Haematology | PubMed URL: | 37452616 | ISSN: | 1600-0609 | Type: | Journal Article | Subjects: | haemorrhage myelodysplastic syndromes platelet transfusion thrombocytopenia |
Appears in Collections: | Journal articles |
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