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Effectiveness of Platelet Transfusion in Leukemia and Aplastic Anemia
Author(s) -
Freireich Emil J.
Publication year - 1966
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/j.1537-2995.1966.tb04691.x
Subject(s) - platelet , aplastic anemia , medicine , platelet transfusion , plasmapheresis , acute leukemia , gastroenterology , hematocrit , leukemia , surgery , immunology , bone marrow , antibody
Hemorrhage resulting from thrombocytopenia in patients with acute leukemia and aplastic anemia can be controlled by platelet transfusions. Severe gross hemorrhage was rarely observed when platelet counts were higher than 20,000 per cu. mm. Transfusion of 1 × 10 11 platelets produced an average increment of 12–14,000 platelets per cu. mm./square meter (m 2 ) of body surface in acute leukemia. One unit of platelet rich plasma (PRP) contains an average of 1 × 10 11 platelets and 4 PRP/m 2 twice weekly will maintain the platelets above 20,000 per cu. mm. most of the time. When very large doses of platelets are required in a small volume then platelet concentrates (PC), prepared by centrifuging PRP and removing most of the plasma, are used. PC are 80 to 90 per cent as effective as PRP in elevating the platelet count if prepared from plasma with a p H of 6.8 or less, achieved by the addition of citric acid. The major hazard of platelet transfusion is posttransfusion hepatitis. This can be minimized by the use of plasmapheresis thus using the same donors repeatedly. In the presence of anemia platelets can be given effectively in fresh whole blood transfusions until the patient's hematocrit is raised.