Trial reportBlood2019
Preterm neonates benefit from low prophylactic platelet transfusion threshold despite varying risk of bleeding or death.
Trial report in Blood, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT06043050 (Sequential Predictions Under Repeated Interventions), which is not on this map. Cited by 30 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Sequential Predictions Under Repeated Interventions: Estimating the Risk of Major Bleeding or Death With and Without Prophylactic Platelet Transfusion in Thrombocytopenic Neonates.
Who cites it
30 citing papers in PubMed, 2 syntheses or guidelines pooled it, 76 citations in OpenAlex.
- Platelet transfusions in preterm infants: current concepts and controversies-a systematic review and meta-analysis.European journal of pediatrics · 2023Pooled it
- Platelet Counts and Patent Ductus Arteriosus in Preterm Infants: An Updated Systematic Review and Meta-Analysis.Frontiers in pediatrics · 2020Pooled it
- Expected individual benefit of prophylactic platelet transfusions in hemato-oncology patients based on bleeding risks.Transfusion · 2021Trial
- Redefining neonatal thrombocytopenia: an evidence-based approach, improved by the refineR algorithm.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Embracing complexity in transfusion research.Vox sanguinis · 2026Review
- Sustained practice change after implementation of an evidence-based neonatal platelet transfusion protocol.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Neonatal Sepsis as Organ Dysfunction: Prognostic Accuracy and Clinical Utility of the nSOFA in the NICU-A Systematic Review.Diagnostics (Basel, Switzerland) · 2026Review
- New perspectives on fetal and neonatal alloimmune thrombocytopenia for obstetricians.Frontiers in immunology · 2026Review
- An improvement project standardizing low prophylactic platelet transfusion dosing for infants.Journal of perinatology : official journal of the California Perinatal Association · 2025Article
- Observational
- Diagnosis and Management of Fetal and Neonatal Alloimmune Thrombocytopenia: An Update 2025.Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie · 2025Review
- Efficacy of Platelet Transfusion in Thrombocytopenia Due to Gram-Negative Late-Onset Neonatal Sepsis.Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion · 2025Article
- Unveiling the Hemostatic Signature of Prematurity: A Prospective Rotational Thromboelastometry-Based Analysis.Medicina (Kaunas, Lithuania) · 2025Article
- If things were simple, word would have gotten around. Can complexity science help us improve pediatric research?Pediatric research · 2025Review
- Platelet and Fibrinogen Contribution to Clot Strength in Premature Neonates with Sepsis.Children (Basel, Switzerland) · 2025Article
- Clinical characteristics, and outcomes of severe neonatal thrombocytopenia: a retrospective cohort study in China.BMC pediatrics · 2025Article
- Implementing evidence-based restrictive neonatal intensive care unit platelet transfusion guidelines.Journal of perinatology : official journal of the California Perinatal Association · 2024Review
- Lowering platelet-count threshold for transfusion in preterm neonates decreases the number of transfusions without increasing severe hemorrhage events.European journal of pediatrics · 2024Article
- Review
- Transfusion strategies for neonates: current perspectives.Annals of medicine and surgery (2012) · 2024Review
Corrections and comments
- Erratum issued
Authors and funding
15 authors at 10 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The Platelets for Neonatal Thrombocytopenia (PlaNeT-2) trial reported an unexpected overall benefit of a prophylactic platelet transfusion threshold of 25 × 109/L compared with 50 × 109/L for major bleeding and/or mortality in preterm neonates (7% absolute-risk reduction). However, some neonates in the trial may have experienced little benefit or even harm from the 25 × 109/L threshold. We wanted to assess this heterogeneity of treatment effect in the PlaNet-2 trial, to investigate whether all preterm neonates benefit from the low threshold. We developed a multivariate logistic regression model in the PlaNet-2 data to predict baseline risk of major bleeding and/or mortality for all 653 neonates. We then ranked the neonates based on their predicted baseline risk and categorized them into 4 risk quartiles. Within these quartiles, we assessed absolute-risk difference between the 50 × 109/L- and 25 × 109/L-threshold groups. A total of 146 neonates died or developed major bleeding. The internally validated C-statistic of the model was 0.63 (95% confidence interval, 0.58-0.68). The 25 × 109/L threshold was associated with absolute-risk reduction in all risk groups, varying from 4.9% in the lowest risk group to 12.3% in the highest risk group. These results suggest that a 25 × 109/L prophylactic platelet count threshold can be adopted in all preterm neonates, irrespective of predicted baseline outcome risk. Future studies are needed to improve the predictive accuracy of the baseline risk model. This trial was registered at www.isrctn.com as #ISRCTN87736839.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.