Platelet transfusions in haematologic malignancies in the last six months of life

Background and objectives Practices in end-of-life platelet transfusions in haematologic malignancies are variable. Our aim was to describe the platelet transfusion burden and parameters linked to this indication in such a setting and thereby contribute to defining optimal practices. Materials and methods From July 2015 to December 2016, all consecutive deceased adult patients with a haematologic malignancy receiving a platelet transfusion in the last 6 months of their life from theEtablissement Francais du Sang Bourgogne Franche-Comtewere included retrospectively. The outcome criteria were changes in the number of platelet transfusions, percent platelet recovery, platelet transfusion interval, reported bleeding with its grade and recipient adverse events in the last 6 months of life. Results Among the 1125 patients monitored, 119 were included in our study. Bleeding prophylaxis (versustreatment) was the reason for 55% of transfusions. 18% of platelet concentrates (n = 1999) were transfused during the last two weeks of life. As death approached, the transfusion and haemorrhage burden increased (P < 0 center dot 0001 in both cases), whereas platelet recovery and transfusion interval decreased (P = 0 center dot 02 in both cases). Recipient adverse events were rare (0 center dot 6%) and of minor severity. Conclusion In end-of-life transfused patients with haematologic malignancies, approaching death is associated with an increased number of platelet transfusions and bleeding events, while platelet recovery and transfusion intervals are reduced. Such findings, together with further evaluations, may contribute to informing best practices for these patients.