Effect of platelet transfusion on hemorrhage in patients with acute leukemia: An autopsy study

Abstract

The effect of platelet transfusion therapy in acute leukemia was studied in 27 cases, whose autopsy findings were compared to 30 similar cases treated prior to availability of such therapy. Major hemorrhage which was considered to be the proximate cause of death was present in 63% of the controls, but occurred in only 15% of the platelet-treated group. This difference was highly significant (p <.001). Of the 30 patients who did not receive intensive platelet therapy, 15 (50%) had gross intracranial hemorrhage and 27 (90%) had gross pulmonary hemorrhage. In contrast, of the 27 patients in the study group who had received platelet therapy, 5 (19%) had gross intracranial hemorrhage and 14 (52%) had gross pulmonary hemorrhage. The platelet-treated patients had a significantly decreased incidence of intracranial hemorrhage (p < .05) and of pulmonary hemorrhage (p <.005) compared to the control group of patients. The incidence of gastrointestinal hemorrhage was slightly lower in the study group; there were no differences in the amount of hemorrhage in the heart and kidney. The transfusion of large numbers of platelets significantly reduced the incidence and severity of hemorrhagic complications in these patients with acute leukemia and may have slightly prolonged their survival.