Several key aspects of platelet (PLT) transfusion supportive care in cancer management remain uncertain. Included are both the optimal transfusion trigger and the optimal PLT dose required to limit bleeding-related morbidity and mortality from thrombocytopenia. This update provides a brief history of PLT transfusion and summarizes the knowledge about factors, including PLT count, that are associated with bleeding risk. International guidelines are available addressing prophylactic PLT transfusion thresholds in both hematologic and solid organ malignancy and the evidence for these guidelines is presented. A number of recently published studies that address both therapeutic PLT transfusion strategies and PLT transfusion dose are then discussed.
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