This protocol places severe demands on blood product resources. Hematology consultation is mandatory before using the protocol for non-hematology patients
Available only in the inpatient setting – HealthLink order set #10397
Indications: Severe thrombocytopenia, refractory to platelet transfusion, and at least one of the following:
- Severe or life-threatening bleeding
- Urgent need for invasive diagnostic lirocedures
- Urgent need for surgery
- Severe thrombocytopenia (expected duration at least 7 days) after high-dose chemotherapy (HLA-matched or crossmatched platelets should be tried first)
Protocol:
IV IgG
Dose: 1 gram/kg/day x 2 days, given as continuous infusion
example: 72 kg person gets 72 grams per 24 hours (3 grams/hour) x 48 hours, total 144 grams.
Please note this is EXTREMELY EXPENSIVE!!
Platelets
Apheresis platelets given as a continuous drip at the rate of one unit every four hours.
Start concomitantly with IV IgG and run for 72 hours
Platelet count typically rises to 100k in 1-2 days and may remain elevated
for 3-7 days.