Platelet transfusions

Platelets are an important component of the blood. They help form clots and stop bleeding by repairing breaks in the walls of blood vessels. A normal platelet count for a healthy child is 150,000/mm3 to 420,000/mm3. Chemotherapy can severely depress the platelet count for some children. If a transfusion is not given when counts are very low, uncontrollable bleeding can result. Many centers require a transfusion when the child's platelet count goes below 10,000 to 20,000/mm3, and sometimes repeat transfusions are required every two or three days until the marrow recovers.

Platelet transfusions are a snap! Platelets are short-lived, and boosted Matt's counts for only a few days, just long enough to get over the danger levels during chemo. He often needed them two to three times every cycle. He had a reaction of hives on one occasion, cured with Bendadryl. Ironically, that was one of the last times he needed platelets.

Three-year-old Matthew had countless platelet transfusions, and only once did he have a reaction. It was an awful thing to watch, but the nurse who was monitoring him was very calm and professional, which helped both of us. Matthew was always premedicated for his platelet transfusions with Benadryl, which made him very drowsy. Most often he would sleep through the entire transfusion.

As with other blood products, platelets are capable of transmitting infections: hepatitis, cytomegalovirus, and HIV (the virus that causes AIDS). The chance of contracting these infections, although small, is the reason that platelet transfusions are also given only when absolutely necessary. Because uncontrollable bleeding can be life threatening, prevention is paramount. Platelet transfusions usually take less than an hour.

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