Solís-Mancilla M, Rivera-Trujillo A, Hernández-Rodríguez S, Carranza-Madrigal J

Language: Spanish
References: 18
Page: 189-197
PDF size: 313.29 Kb.

ABSTRACT

Objective: To evaluate the prescription of platelet transfusion and the evolution of patients with primary immune thrombocytopenia in a general hospital.
Material and Method: An observational, analytical, retrospective and longitudinal study was made from January 2011 to December 2016 in all patients with primary immune thrombocytopenia attended for 5 years; compliance with transfusion criteria, refractoriness to transfusion and its evolution after 6 months were assessed.
Results: 31% of the patients did not have a correct indication for platelet transfusion; the direction of the platelet count with the passage of time was towards the rise in the group with an appropriate indication, which did not present any relapse. The number of platelets was significantly higher in the group of non-transfused patients compared to those who received transfusion therapy with a significantly shorter hospital stay; 37% of transfused patients had refractoriness that was not associated with the correct indication of transfusion. All the multitransfused patients presented refractoriness.
Conclusions: A high percentage of inadequate platelet transfusion was found according to the criteria established for it.

REFERENCES

1. Meillón LA, Chávez J, Almaguer D, Guillermo R, Espíndola GR, Murillo C. Trombocitopenia inmune primaria (TIP) del adulto en México: características nacionales y su relación con la literatura internacional. Gac Méd Méx 2014 May;(150):279-88.

2. Godeau B, Provan D, Bussel J. Immune thrombocytopenic purpura in adults. Curr Opin Hematol 2007 Sep;(14):535- 56.

3. Abrahamson PE, Hall SA, Feudjo M, Tepie M, Gold FS, Logie J. The incidence of idiopathic thrombocytopenic purpura among adults: A population-based study and literature review. Eur J Hematol 2009 Aug;(83):83-89.

4. Lozano ML, Vicente V. Current treatment of primary immune thrombocytopenia. Med Clin (Barc) 2014 May;142(9):399-405.

5. Alvarado M, Campos G, Flores V, García J, Gutierrez GR, Leyto F, et al. Primary Immune Thrombocytopenia In Adults: Updated review on Diagnosis And Treatment. Int J Recent Sci Res 2017 Jan;(8):15364-15370.

6. Provan D, Stasi R, Newland AC, Blanchette VS, Maggs P, Bussel JB, et al. International consensus report on the investigation and management of primary immune thrombocytopenia. Blood 2010 Jan;(115):168-186.

7. Fernández A. Directrices de diagnóstico, tratamiento y seguimiento de la PTI: Documento de Consenso. Consenso Español de Hematología 2008;83:122-5.

8. Espíndola G, Murillo C, Martínez P. Guía de Práctica Clínica Diagnóstico y Tratamiento de Púrpura Trombocitopenica Inmunológica. México; Secretaría de Salud; 2009.

9. Jeffrey MC. Overview of Platelet Transfusion. Semin Hematol. 2010 Jul; (47):235-242.

10. Bruce D. Platelet transfusions: the science behind safety, risks and appropriate applications. Best Pract Res Clin Anaesthesiol 2010 Mar;24:65-83.

11. Greeno E, McCullough J, Weisdorf D. Platelet utilization and the transfusion trigger: a prospective analysis. Transfusion 2007 Feb;2:201-5.

12. Marwaha N, Sharma R. Consensus and controversies in platelet transfusion. Transfus Apher Sci 2009 Oct;41:127-133.

13. Sanz MA, García VV, Fernández A, López M, Grande C, Jarque I, et al. Diagnóstico, tratamiento y seguimiento de la trombocitopenia inmune primaria. Med Clin (Barc) 2012 Mar;6:261.e1-261.e17.

14. Hod E, Schwartz J. Platelet transfusion refractoriness. Br J Haematol 2008 Jul;3:348-60.

15. Forest SK, Hod EA. Management of the platelet refractory patient. Hematol Oncol Clin N Am 2016 Jun;30:665-677.

16. Martini R, Horner R, Rodríguez MA, Kempfer CB, Tizotti MK, Ratzlaff. Bacteriological analysis of platelets and cases of septic reactions associated with transfusion of contaminated samples. Transfus Apher Sci 2012 Dec;47: 313-318.

17. Arkfeld DG, Weitz IC. Immune thrombocytopenia in patients with connective tissue disorders and the antiphospholipid antibody syndrome. Hematol Oncol Clin N Am 2009 Mar;23:1239-1249.

18. Neunert C, Lim W, Crowther M, et al. The American Society of Hematology 2011 evidence-based practice guideline for immune thrombocytopenia. Blood 2011 Jan;16:4190-4207.