The platelet count should be rechecked in 24 hours. Although this patient is significantly thrombocytopenic, phase III clinical trial data do not support the use of prophylactic platelet transfusions for patients with acute myeloid leukemia (AML) whose platelet count is 10,000/µL (10 × 10⁹/L) or higher. Randomized studies have been published comparing a platelet transfusion threshold of 10,000/µL (10 × 10⁹/L) to 20,000/µL (20 × 10⁹/L) in stable patients with AML undergoing induction or consolidation chemotherapy; all have demonstrated equivalent outcomes with respect to clinically significant bleeding, need for erythrocyte transfusions, and mortality during induction chemotherapy. Therefore, these data support and guidelines recommend a threshold of 10,000/µL (10 × 10⁹/L) for prophylactic platelet transfusion in hospitalized patients with thrombocytopenia due to decreased bone marrow production. Patients with acute promyelocytic leukemia (APL), fever, clinically significant bleeding, or a need for invasive procedures were not evaluated in these studies and are typically transfused at a threshold of 20,000/µL (20 × 10⁹/L).

Transfusion of leukoreduced, irradiated platelets would be appropriate if the patient's platelet count decreases to less than 10,000/µL (10 × 10⁹/L). HLA-matched platelets would only be used if the patient had a history of platelet transfusion refractoriness attributed to platelet alloantibodies. Washing of platelets leads to loss of platelet numbers and function and is reserved for patients with a history of a severe allergic reaction to a transfused blood product (such as anaphylaxis in a patient with IgA deficiency).