RCT | 2-y outcomes confirm the harms caused by high prophylactic platelet transfusion thresholds in preterm infants

Summary: The study investigated the long-term outcomes of preterm infants who participated in a randomized trial of platelet transfusions at different threshold levels. Infants with platelet counts below 50×109/L were enrolled and randomized to either a higher threshold of 50×109/L or a lower threshold of 25×109/L. The study found that infants randomized to the higher threshold had a higher rate of death or significant neurodevelopmental impairment at a corrected age of 2 years compared to the lower threshold group. The study further supports evidence of harm caused by high prophylactic platelet transfusion thresholds in preterm infants. The mechanisms by which platelet transfusions could mediate harmful effects remain unknown, but the study identified increased rates of intraventricular hemorrhage and bronchopulmonary dysplasia in the higher threshold group, which may contribute to the adverse outcomes observed.

Article: Two-year outcomes following a randomised platelet transfusion trial in preterm infants – ADC Fetal & Neonatal

Original Study: Randomized Trial: Platelet-Transfusion Thresholds in Neonates

Commentary from the author on Twitter (thread – click for more)

We already knew from the @PlaNeT2_trial that a higher prophylactic platelet transfusion threshold (<50) in preterm babies is associated with significantly increased mortality or major bleeding compared with a lower one (<25)… https://t.co/pJrE44BIIx

— Carmel Moore (@carmelmoore) February 22, 2023