A patient with chemotherapy-induced marrow aplasia has a platelet count of 8,000 per microlitre, is afebrile, and has no bleeding. According to standard prophylactic practice, what should be done?

• A Defer transfusion until bleeding appears
• B Transfuse only if the count falls below 5,000 per microlitre
• C Transfuse platelets now ✓
• D Give DDAVP instead of platelets

Explanation

The accepted prophylactic trigger for platelet transfusion in hypoproliferative thrombocytopenia is a count below 10,000 per microlitre, based on randomised evidence showing spontaneous serious haemorrhage becomes likely below this level while transfusion risk remains acceptable. Higher thresholds of 20,000 apply with fever or sepsis, and 50,000 before invasive procedures or minor surgery. Therapeutic-only strategies increase bleeding events without reducing transfusion use.

Reference: Williams Hematology, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.