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Peer-reviewedCC BY 4.0Journal of Clinical Medicine

Patient Blood Management for Platelet Transfusion: Current Evidence, Safety Concerns and Practical Implementation in Hematology

  • Maria Eva Mingot-Castellano1
  • Rocio Cardesa Cabrera2
  • Maria Angeles Dominguez Muñoz3
  • Maria Amparo Pimentel Villar3
  • Nancy Rodriguez Torres4
4 affiliations
  1. 1Servicio de Hematología, Hospital Universitario Virgen del Rocio, Instituto de Biomedicina de Sevilla (IBIS/CSIC), Universidad de Sevilla, 41013 Sevilla, Spain
  2. 2Servicio de Hematología, Hospital de la Merced, Osuna, 41640 Sevilla, Spain
  3. 3Servicio de Hematología, Hospital Universitario Virgen de Valme. 41014 Sevilla, Spain
  4. 4Servicio de Hematología, Hospital Universitario Virgen del Rocio, 41013 Sevilla, Spain
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Abstract

Platelet transfusion is essential in hematology and oncology but remains characterized by practice variability, uneven certainty of evidence across clinical settings, short component shelf life and clinically relevant adverse effects. This narrative review integrates evidence on efficacy, thresholds and dosing, safety, and implementation of platelet-specific patient blood management (PBM). In stable non-bleeding therapy-induced thrombocytopenia, a restrictive prophylactic threshold of 10 × 109/L is supported by randomized evidence and contemporary guidelines, whereas higher thresholds increase exposure without consistent clinical benefit. Therapeutic-only strategies reduce utilization but are not equally safe across populations, particularly in acute leukemia. Platelet PBM should therefore combine indication-specific protocols, a single-adult-dose policy with reassessment, audit and feedback, post-transfusion response monitoring, refractoriness management, inventory stewardship and multidisciplinary governance. The objective is not simply fewer transfusions but fewer unnecessary transfusions with preserved hemostatic safety.

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Cite

BibTeXRIS
BibTeX
@article{mingotcastellano2026patient,
  title = {{Patient Blood Management for Platelet Transfusion: Current Evidence, Safety Concerns and Practical Implementation in Hematology}},
  author = {Maria Eva Mingot-Castellano and Rocio Cardesa Cabrera and Maria Angeles Dominguez Muñoz and Maria Amparo Pimentel Villar and Nancy Rodriguez Torres},
  journal = {Journal of Clinical Medicine},
  year = {2026},
  month = nov,
  doi = {10.3390/jcm15218747},
  url = {https://www.mdpi.com/2077-0383/15/21/8747},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Patient Blood Management for Platelet Transfusion: Current Evidence, Safety Concerns and Practical Implementation in Hematology
AU  - Maria Eva Mingot-Castellano
AU  - Rocio Cardesa Cabrera
AU  - Maria Angeles Dominguez Muñoz
AU  - Maria Amparo Pimentel Villar
AU  - Nancy Rodriguez Torres
PY  - 2026
DA  - 2026/11/09
JO  - Journal of Clinical Medicine
DO  - 10.3390/jcm15218747
UR  - https://www.mdpi.com/2077-0383/15/21/8747
AB  - Platelet transfusion is essential in hematology and oncology but remains characterized by practice variability, uneven certainty of evidence across clinical settings, short component shelf life and clinically relevant adverse effects. This narrative review integrates evidence on efficacy, thresholds and dosing, safety, and implementation of platelet-specific patient blood management (PBM). In stable non-bleeding therapy-induced thrombocytopenia, a restrictive prophylactic threshold of 10 × 109/L is supported by randomized evidence and contemporary guidelines, whereas higher thresholds increase exposure without consistent clinical benefit. Therapeutic-only strategies reduce utilization but are not equally safe across populations, particularly in acute leukemia. Platelet PBM should therefore combine indication-specific protocols, a single-adult-dose policy with reassessment, audit and feedback, post-transfusion response monitoring, refractoriness management, inventory stewardship and multidisciplinary governance. The objective is not simply fewer transfusions but fewer unnecessary transfusions with preserved hemostatic safety.
SN  - 2077-0383
ER  -