DETERMINATION OF OPTIMAL PROPHYLACTIC PLATELET DOSE STRATEGY TO PREVENT BLEEDING

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. As platelet use continues to increase at a high rate, it is important to identify the most cost-effective strategies for providing platelet support, which is crucial for effective disease management. The optimal quantity of platelets that should be given per transfusion remains uncertain, and no prospective platelet transfusion trials have been performed. This study will investigate the safety of three different dosing strategies for inpatients with low platelets due to stem cell transplants or chemotherapy. We will measure how effective each of these is in prevention of a fairly low amount of bleeding. The results of this trial could have a major effect on standard medical practice. The Platelet Dose Trial is a multi-site trial that will enroll 1,350 patients in the United States. Patients will randomly receive one of the following: a lower dose of platelets than usual, a medium, fairly usual dose or a higher than usual dose. They will receive platelets any time their morning platelet count falls below 10,000. If the post-transfusion platelet count is not over 10,000, the physician will be able to order another platelet transfusion but is not required to do so. The protocol also allows for additional platelets to be given when procedures need to be done or when there is active bleeding. Assessment of bleeding by study personnel will be performed daily by means of physical assessment of the patient, patient interview and review of patient chart and laboratory data.