Grant: Operating Grant

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, platelet transfusions 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 a patient's quality of life. Additionally, the potential overuse of platelet products places a burden on a scarce and valuable health care resource. The benefit of the current practice of routine platelet transfusions (prophylactic) to prevent hemorrhage in patients not admitted to the hospital is unknown. An alternative strategy involves only administering platelets to control active bleeding (therapeutic). 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. We propose to perform a pilot randomized controlled trial to determine if a strategy of therapeutic platelet transfusions is safe and effective in outpatients with blood cancers and low platelet counts. The primary outcome of this study will be the feasibility of performing a larger clincal trial. We will assess recruitment, adherence to the assigned platelet transfusion strategies and compliance with followup monitoring.