AFSOS 2022 – Thrombocytopenia and Most cancers Repository
Throughout a devoted session on 14e congress of the Francophone Affiliation of Oncological Assist Care (AFSOS, October 20-21, 2022, Lille), Audrey Eche Gass, basic practitioner within the assist oncological care division on the IUCT-Oncopole (Toulouse)recalled the details of the AFSOS reference doc ‘Thrombocytopenia and Most cancers’ printed this 12 months. In onco-haematology, the variety of thrombocytes used to outline thrombocytopenia is 100 Giga/L. It generates a haemorrhagic danger, could impose a delay in chemotherapy and a potential discount within the dose-intensity of most cancers therapies. Its etiology should be sought with a view to decide particularly its central origin (Infiltration of the bone marrow by the tumour, thrombocytopenia of continual illnesses, myelodysplasia within the aged, and so on.), peripheral (autoimmune, immuno-allergic, alloimmune, by overconsumption of platelets or hypersplenism) or poisonous (particularly most cancers therapies).
Medical indicators of thrombocytopenia ought to be sought (gingivorrhagia, purpura, petechiae, hematomas, and so on.) with out forgetting to suspect potential inner bleeding. Biologically, the evaluation should embody the blood rely, the platelet rely ought to ideally be carried out on an EDTA tube and citrate management if obligatory, and a blood smear which confirms the shortage of platelets and the absence of platelet aggregates. Different explorations could also be thought of relying on the outcomes and the medical context (ionogram, CRP, haemostasis evaluation, myelogram, and so on.).
When platelet transfusion is envisaged, it imposes knowledgeable info of the affected person and the presence of a physician on website is critical throughout this medical act. Dosage is predicated on affected person weight and platelet rely, and depends on the illness. The same old dosage is 0.5 to 0.7 x 1011 pads/10 kg of weight, “ however don’t hesitate to contact the referring physician of the French Blood Institution in case of doubt. Platelets are fragile merchandise, in order that they should be administered shortly (inside 4 hours) for the transfusion to be efficient. “.
The rules suggest choice bushes regarding the indication of platelet transfusion within the occasion of central thrombocytopenia, which is determined by the existence of bleeding, the severity of the thrombocytopenia and the prospect of a change within the variety of platelets (associated to surgical procedure for instance).
The analysis of efficacy 48 hours after the transfusion will not be systematically carried out regardless that it’s important to regulate therapy or to hunt explanatory causes or medicine favoring thrombocytopenia. “ If the variety of platelets doesn’t rise, it’s potential that the transfused bag was not wealthy sufficient in platelets or too outdated. Don’t hesitate to calculate the yield of platelet transfusion with a haemovigilance or EFS correspondent she insisted.
The repository, which may be consulted on the AFSOS web site, presents choice bushes for describing the motion to be taken within the occasion of idiopathic thrombocytopenic purpura, disseminated intravascular coagulation or thrombotic microangiopathy, in addition to particulars regarding the motion to be taken in a thrombocytopenic affected person handled with anticoagulant or antiplatelet agent.
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