Transfusion Policy for Patients Undergoing Myeloablative Chemotherapy

1. All blood products should be irradiated
2. RBC transfusions to keep Hgb at or above 8 gm/dl (may transfuse to
   higher-level for symptoms of anemia or comorbid disease); Order one unit
   at a time in most instances, order set available in HealthLink)
3. Platelets (order set available in HealthLink)
   1. whenever platelets < 10K
   2. for platelets < 30-50K and
      1. active bleeding
      2. invasive procedure
      3. known bleeding site or history of bleeding at a similar platelet count
      4. sepsis or DIC

For patients who are refractory to random donor platelets:

1. Check for HLA antibody (Order “HLA Class I Antibody by
Luminex”)

2. If such an antibody is found, give HLA-identical, HLA-compatible, or
crossmatched platelets (contact blood bank for details)

3. If this proves unsuccessful, or in an emergency when there is no time
to try the above, consider using
combination IVIG and platelet infusion

Reviewed July 2016