{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T18:24:49Z","timestamp":1788200689771,"version":"build-2803163510"},"reference-count":28,"publisher":"American Society of Hematology","issue":"26","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,12,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The Platelets for Neonatal Thrombocytopenia (PlaNeT-2) trial reported an unexpected overall benefit of a prophylactic platelet transfusion threshold of 25 \u00d7 109\/L compared with 50 \u00d7 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 \u00d7 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 \u00d7 109\/L- and 25 \u00d7 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 \u00d7 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 \u00d7 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.<\/jats:p>","DOI":"10.1182\/blood.2019000899","type":"journal-article","created":{"date-parts":[[2019,10,24]],"date-time":"2019-10-24T15:30:12Z","timestamp":1571931012000},"page":"2354-2360","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":71,"title":["Preterm neonates benefit from low prophylactic platelet transfusion threshold despite varying risk of bleeding or death"],"prefix":"10.1182","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1607-2581","authenticated-orcid":false,"given":"Susanna F.","family":"Fustolo-Gunnink","sequence":"first","affiliation":[{"name":"Center for Clinical Transfusion Research, Sanquin Research, Leiden, The Netherlands;"},{"name":"Pediatric Hematology, Emma Children\u2019s Hospital, Amsterdam University Medical Center (UMC), University of Amsterdam, The Netherlands;"},{"name":"Department of Epidemiology, Leiden University Medical Center, Leiden, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0904-4360","authenticated-orcid":false,"given":"Karin","family":"Fijnvandraat","sequence":"additional","affiliation":[{"name":"Pediatric Hematology, Emma Children\u2019s Hospital, Amsterdam University Medical Center (UMC), University of Amsterdam, The Netherlands;"},{"name":"Department of Molecular Cellular Hemostasis, Sanquin Research, Amsterdam, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2096-606X","authenticated-orcid":false,"given":"David","family":"van Klaveren","sequence":"additional","affiliation":[{"name":"Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands;"},{"name":"Predictive Analytics and Comparative Effectiveness Center, Tufts Medical Center, Boston, MA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon J.","family":"Stanworth","sequence":"additional","affiliation":[{"name":"Transfusion Medicine, National Health Service (NHS) Blood and Transplant, Oxford, United Kingdom;"},{"name":"Department of Haematology, Oxford University Hospitals, NHS Foundation Trust, Oxford, United Kingdom;"},{"name":"Radcliffe Department of Medicine, Biomedical Research Centre (BRC) Haematology Theme, University of Oxford, Oxford, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Curley","sequence":"additional","affiliation":[{"name":"Department of Neonatology, National Maternity Hospital, Dublin, Ireland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9623-0606","authenticated-orcid":false,"given":"Wes","family":"Onland","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Emma Children\u2019s Hospital, Amsterdam UMC, Amsterdam, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7787-0122","authenticated-orcid":false,"given":"Ewout W.","family":"Steyerberg","sequence":"additional","affiliation":[{"name":"Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"de Kort","sequence":"additional","affiliation":[{"name":"Department of Neonatology, M\u00e1xima Medical Center, Veldhoven, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther J.","family":"d\u2019Haens","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Amalia Children\u2019s Center, Zwolle, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian V.","family":"Hulzebos","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Beatrix Children\u2019s Hospital, University Medical Center Groningen, Groningen, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0700-2194","authenticated-orcid":false,"given":"Elise J.","family":"Huisman","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology, Erasmus Medical Center\/Sophia Children\u2019s Hospital, Rotterdam, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3194-7005","authenticated-orcid":false,"given":"Willem P.","family":"de Boode","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Radboud University Medical Center, Nijmegen, The Netherlands; 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