Purpose To provide evidence-based guidance on the use of platelet transfusion in people with cancer. This guideline updates and replaces the previous ASCO platelet transfusion guideline published initially in 2001. Methods ASCO convened an Expert Panel and conducted a systematic review of the medical literature published from September 1, 2014, through October 26, 2016. This review builds on two 2015 systematic reviews that were conducted by the AABB and the International Collaboration for Transfusion Medicine Guidelines. For clinical questions that were not addressed by the AABB and the International Collaboration for Transfusion Medicine Guidelines (the use of leukoreduction and platelet transfusion in solid tumors or chronic, stable severe thrombocytopenia) or that were addressed partially (invasive procedures), the ASCO search extended back to January 2000. Results The updated ASCO review included 24 more recent publications: three clinical practice guidelines, eight systematic reviews, and 13 observational studies. Recommendations The most substantial change to a previous recommendation involved platelet transfusion in the setting of hematopoietic stem-cell transplantation. Based on data from randomized controlled trials, adult patients who undergo autologous stem-cell transplantation at experienced centers may receive a platelet transfusion at the first sign of bleeding, rather than prophylactically. Prophylactic platelet transfusion at defined platelet count thresholds is still recommended for pediatric patients undergoing autologous stem-cell transplantation and for adult and pediatric patients undergoing allogeneic stem-cell transplantation. Other recommendations address platelet transfusion in patients with hematologic malignancies or solid tumors or in those who undergo invasive procedures. Guidance is also provided regarding the production of platelet products, prevention of Rh alloimmunization, and management of refractoriness to platelet transfusion ( www.asco.org/supportive-care-guidelines and www.asco.org/guidelineswiki ).

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癌症患者的血小板输注：美国临床肿瘤学会临床实践指南更新

目的 为癌症患者使用血小板输注提供循证指导。本指南更新并取代了最初于 2001 年发布的先前 ASCO 血小板输注指南。 方法 ASCO 召集了一个专家小组并对 2014 年 9 月 1 日至 2016 年 10 月 26 日发表的医学文献进行了系统回顾。本次回顾建立在 2015由 AABB 和国际输血医学合作指南进行的系统评价。对于 AABB 和国际输血医学合作指南未解决的临床问题（在实体瘤或慢性、稳定的严重血小板减少症中使用白细胞减少和血小板输注）或部分解决（侵入性操作），ASCO 检索可追溯到 2000 年 1 月。结果 更新的 ASCO 综述包括 24 篇较新的出版物：三篇临床实践指南、八篇系统综述和 13 篇观察性研究。建议 对先前建议的最重大变化涉及在造血干细胞移植中输注血小板。根据随机对照试验的数据，在经验丰富的中心接受自体干细胞移植的成年患者可能会在出现出血的第一个迹象时接受血小板输注，而不是预防性输注。对于接受自体干细胞移植的儿科患者以及接受同种异体干细胞移植的成人和儿科患者，仍建议在规定的血小板计数阈值下进行预防性血小板输注。其他建议涉及血液系统恶性肿瘤或实体瘤患者或接受侵入性手术的患者的血小板输注。还提供了关于血小板产品的生产、Rh 同种免疫的预防和血小板输注难治性管理的指导（www.asco.org/supportive-care-guidelines 和 www.asco.org/guidelineswiki）。