1615. Platelet Kinetics of Prophylactic Platelet Transfusion in Adult Dengue
Session: Poster Abstract Session: Global Health
Saturday, October 10, 2015
Room: Poster Hall
Posters
  • ADEPT_Platelet Kinetics Poster_IDWeek 2015.pdf (549.3 kB)
  • Background:

    Thrombocytopenia is common in dengue. Prophylactic platelet transfusion is widely practiced but platelet response kinetics in adult patients is not well described.

    Methods:

    A multicenter, open-label, randomized study of prophylactic platelet transfusion versus supportive care in adult dengue patients with platelet counts ≤20x103/µL was conducted in 5 hospitals in Singapore and Malaysia. Platelet outcomes studied were: platelet increment at 1, 12 and 24 hours post-transfusion, daily platelet count until discharge or study day 7, and median time to platelet count >50x103/µL.

    Results:

    182 patients were randomized to supportive care and 187 to prophylactic platelet transfusion with similar baseline age, gender, co-morbidities, clinical bleeding, warning signs and disease severity between the two groups. The median platelet increment (x103/µL) among transfused patients at 1 hour was 16 (interquartile range [IQR], 8-24), 12 hours was 13 (IQR, 5-22) and 24 hours was 25 (IQR, 13-41). Median platelet count change (x103/µL) was significantly lower in the non-transfused than transfused group on study day 2 (5 [IQR, -1-12] versus 13 [IQR, 3-22], p<0.001), but was similar from study day 3 (27 [IQR, 12-47] versus 28 [IQR, 15-49], p=0.500) to day 7 (111 [IQR, 47-299] versus 119 [IQR, 64.5-186], p=0.860). By study day 7, 100 (55.0%) of supportive care and 109 (58.3%) of transfused group patients had platelet counts >50x x103/µL (p=0.530). Median time to platelet count >50x x103/µL was 4 days in both groups (p=0.389). More adverse events occurred in the prophylactically transfused than non-transfused group (13 [6.9%] versus 2 [1.1%], p=0.006).

    Conclusion:

    Platelet response to prophylactic platelet transfusion was transient. Adverse events were more common among platelet-transfused patients.

    David Lye, MBBS1, Sophia Archuleta, MD2,3, S Omar, MBBS4, Jenny G Low, MBBS, MRCP, MPH5, H Oh, MBBS6, Yuan Wei, MSc7, Paul Ananth Tambyah, MD8, YS Leo, MPH1 and ADEPT Study Group, (1)Tan Tock Seng Hospital, Singapore, Singapore, (2)Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore, (3)Division of Infectious Diseases, University Medicine Cluster, National University Hospital, Singapore, Singapore, (4)University Malaya Medical Centre, Kuala Lumpur, Malaysia, (5)Singapore General Hospital, Singapore, Singapore, (6)Changi General Hospital, Singapore, Singapore, (7)Singapore Clinical Research Institute, Singapore, Singapore, (8)Dept of Med,Div of ID, National University of Singapore, Singapore, Singapore

    Disclosures:

    D. Lye, None

    S. Archuleta, None

    S. Omar, None

    J. G. Low, None

    H. Oh, None

    Y. Wei, None

    P. A. Tambyah, None

    Y. Leo, None

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