Platelet use in pediatric oncology: a review of 393 transfusions.

A total of 393 platelet transfusions, administered on the pediatric service at the M. D. Anderson Hospital and Tumor Institute between March, 1973, to December, 1974, were reviewed. Of these 64 were administered on indications of hemorrhage or surgery, while 324 were administered prophylactically. In only 33% was an adequate platelet rise seen, and in only 40% of those bleeding was the bleeding controlled. The primary factor precluding the success was the number of previously administered platelet transfusions. Infection, the use of random or single donors, and ABO matching had no effect on the outcome, but this was not accentuated in the bleeding patients. Surprisingly, transfusions in patients with leukemia resulted in greater success than transfusions in patients with solid tumors. The lower the platelet count prior to transfusion, the less likely the transfusion was to be successful.