Current status and problem of platelet transfusion for hematopoietic diseases: results from a questionnaire survey

We carried out a survey on platelet transfusions performed in hospitals certified by the Japanese Society of Hematology. The average values of the pretransfusion platelet count (trigger value) for the day on which the transfusion was ordered, and the values on each day in the interval between the order and actual transfusion, were compared with the Guidelines. The average trigger value in aplastic anemia and myelodysplastic syndrome patients (A group) (1.41 x 10(4)/microl) for the same day on which the transfusion was ordered was higher than the Guideline, whereas those patients with hematological disorders undergoing chemotherapy (B group) and hematopoietic stem cell transplantation (C group), namely 2.08 x 10(4)/microl and 2.1 x 10(4)/microl, respectively, were acceptable values when compared with the Guidelines. On the other hand, in all groups, the transfusion trigger values at one or two days after ordering were higher than the Guidelines, being 2.56 x 10(4)/microl in the A group, 3.15 x 10(4)/microl in the B group, and 2.59 x 10(4)/microl in the C group. We have tried to formulate platelet count criteria for ordering a transfusion based on one day before the actual transfusion, because these platelet counts on ordering were relatively high. The criteria are 1.0-1.5 x 10(4)/microl in group A, 3.0 x 10(4)/microI in group B, and 3.0 x 10(4)/microl in group C. In order to perform platelet transfusion according to the Guidelines, the platelet count on ordering should be decreased as we proposed.