Bloody Minded Episode 43 - When your number’s not up | Platelet Refractoriness
Apr 22, 2025
Dive into the complexities of platelet refractoriness and its impact on transfusion medicine. Explore the immune mechanisms that trigger poor responses despite transfusions, and learn about the crucial role of HLA matching in improving outcomes. The discussion covers the importance of understanding platelet increments and the various factors leading to refractoriness, including infections and medications. Discover innovative management strategies to enhance donor availability and minimize complications, making transfusions safer and more effective.
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Patient Platelet Refractoriness Case
- A 34-year-old AML patient showed no platelet count increase after transfusions, suspicious for immune-mediated refractoriness.
- Platelet increments can be highly variable, sometimes responding inconsistently to transfusions.
What Platelet Refractoriness Means
- Platelet refractoriness means transfused platelets fail to increment as expected, raising bleeding risk.
- It's common in hematology patients due to platelet transfusion dependency and alloimmunisation risks.
Defining Platelet Refractoriness
- Platelet refractoriness is defined by low post-transfusion platelet increments or corrected count increment (CCI).
- CCI accounts for patient size and platelet dose, providing a more accurate measure than simple count difference.