Platelets transfusion for patients with hypoproliferative thrombocytopenia

Why did ICTMG develop a guideline for platelet transfusion?

The number of patients with severe hypoproliferative thrombocytopenia and the duration of thrombocytopenia have increased, as has the need for platelet support to reduce the risk of hemorrhage. The ICTMG developed a guideline that considers recently published key platelet transfusion trials.

ICTMG's recommendations provide a comprehensive guideline for treating patients with hypoproliferative thrombocytopenia who are at risk for hemorrhage and for whom platelet transfusion support needs to be optimized.

How to access the ICTMG publications

ICTMG developed two systematic reviews:

Pavenski K, Rebulla P, Duquesnoy R, Saw CL, Slichter SJ, Tanael S, Shehata N, International Collaboration for Guideline Development. Efficacy of HLA-Matched Platelet Transfusions for Patients with Hypoproliferative Thrombocytopenia: A Systematic Review. Transfusion 2013; 53: 2230-42.

To download a pdf of the article click here.

To download the supplemental tables and appendixes click here.

Vassallo RR, Fung M, Rebulla P, Duquesnoy R, Saw CL, Slichter SJ, Tanael S, Shehata N, International Collaboration for Guideline Development. Utility of Cross-Matched Platelet Transfusions in Patients with Hypoproliferative Thrombocytopenia: A Systematic Review. Transfusion 2014; 54: 1180-91.

To download a pdf of the article click here.

To download the supplemental tables and appendixes click here.

ICTMG's guideline on the management of patients with hypoproliferative thrombocytopenia was published in Transfusion Medicine Review in 2015:

Nahirniak S, Slichter SJ, Tanael S, Rebulla P, Pavenski K, Vassallo R, Fung M, Duquesnoy R, Saw C-L, Stanworth S, Tinmouth A, Hume H, Ponnampalam A, Moltzan C, Berry B, Shehata N. Guidance on Platelet Transfusion for Patients with Hypoproliferative Thrombocytopenia. Transfus Med Rev 2015; 29: 3-13.

To download a pdf of the article click here.

To download the supplemental tables and appendixes click here.

In 2020, ICTMG conducted a systematic review to appraise the quality of evidence-based clinical practice guidelines pertaining to platelet transfusions:

Al-Riyami AZ, Jug R, La Rocca U, Keshavarz H, Landry D, Shehata N, Stanworth SJ, Nahirniak S. Quality of Evidence-based Guidelines for Platelet Transfusion and Use: A Systematic Review. Transfusion 2021; 61: 948-958.

To download a pdf of the article click here.

To download the supplemental tables and appendixes click here.

ICTMG guideline updates

The ICTMG is committed to updating its guideline regularly. An ICTMG Guideline Development Group is currently working on an update for the 2015 guideline - anticipated completion date is sometime in late 2021.

Additional resources for physicians

Platelet algorithm

Print out the decision-making algorithm summarizing ICTMG's guidance on platelet transfusion for patients with hypoproliferative thrombocytopenia.

Journal Club webcast

View a webcast to learn more about the ICTMG systematic review Quality of Evidence-based Guidelines for Platelet Transfusion and Use: A Systematic Review. This webcast was recorded through a partnership with ISBT.

Journal Club objectives:

Apply the AGREE II tool in evaluating the existing platelet guidelines
Discuss the limitations of the published platelet guidelines

Panelists:

Professor Simon Stanworth - Panel moderator

Dr. Arwa Al-Riyami
Dr. Rachel Jug
Dr. Ursula La Rocca

ICTMG platelet guidelines

This presentation from 2016 provides an overview of ICTMG's process for developing guidelines and the supporting evidence for platelet transfusion in patients with hypoproliferative thrombocytopenia. Please use or adapt our presentation for educational or training purposes.

Podcast - Platelets unplugged: The sticky truth (podcast)

Brought to you by the AABB and the ICTMG

Dr. Richard Wells moderates this podcast conversation with Dr. Richard Kaufman and Dr. Susan Nahirniak as they peel back the layers on two platelet transfusion guidelines published by ABBB in 2015 and ICTMG in 2015. Learn about the guidelines, how they were generated, the evidence behind them, and remaining gaps in knowledge.

International reach

National Advisory Committee on Blood and Blood Products (Canada)

In August 2018, the National Advisory Committee (NAC) on Blood and Blood Products (Canada) endorsed the ICTMG guidance on platelet transfusion for patients with hypoproliferative anemia (Nahirniak et al. 2015). Read the NAC statement here.

In the news

NHS Blood and Transplant

ICTMG's 2021 systematic review of the quality of evidence-based guidelines for platelet transfusion and use was selected by the UK's NHS Blood and Transplant Systematic Review Initiative as one of the top 10 publications in March 2021.

Canadian Blood Services

In Canadian Blood Services' Research, Education and Discovery Blog, ICTMG member Dr. Arwa Al-Riyami highlights key takeaways from ICTMG's 2021 systematic review of quality of evidence-based guidelines for platelet transfusion and use.

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