Platelet Transfusion for Patients with Cancer: An Update.

Abstract

Background: Platelet transfusion is essential for preventing and treating hemorrhage in oncology patients and can markedly improve quality of life and survival. However, access to platelet concentrates is often limited by global shortages and logistical constraints, especially in low-resource settings.

Summary: Maintaining product quality requires stringent donor screening, pathogen-reduction technologies, and optimized storage conditions to preserve hemostatic function and reduce adverse reactions. Common transfusion-related complications (e.g., alloimmunization, non-hemolytic reactions, and circulatory overload) underscore the importance of real-time monitoring and individualized transfusion protocols. Emerging thrombopoietin receptor agonists, such as romiplostim and eltrombopag, exhibited benefit in reducing transfusion dependency and merit further study in cancer-associated thrombocytopenia. This review aims to summarize the research advances and clinical guidelines on platelet transfusion, including platelet production methods, transfusion dosage, pathogen inactivation, leucocyte depletion, types of cancer-related thrombocytopenias, and platelet transfusion strategies and to discuss future research directions and perspectives.

Key messages: While platelet transfusions remain indispensable for mitigating bleeding risk in immunotherapy and CAR-T recipients, the heterogeneity of patient responses underscores the need for prospective trials to evaluate the impact of transfusion practices on both hemostatic and immunologic outcomes.