Post-transfusion platelet increments and what else are used to evaluate platelet refractoriness?

• A. Post-transfusion platelet increments and corrected count increment (CCI).
• B. Hematocrit changes only.
• C. Serum ferritin levels.
• D. Platelet morphology.

Answer: (A)

Assessing platelet refractoriness relies on how the patient’s platelets respond after a transfusion. After a platelet transfusion, you measure the rise in the circulating platelet count at about 1 hour and again at 24 hours. The simple post-transfusion platelet increment shows how much the count increased, but because patient size and the number of platelets given vary, you also use the corrected count increment (CCI). The CCI adjusts the observed rise for body surface area and the dose transfused, allowing apples-to-apples comparison across transfusions and patients. If the CCI is consistently low on these checks, this indicates refractoriness, which can be immune (antibody-mediated) or non-immune in nature.

Hematocrit changes reflect red cell transfusion efficacy, so they aren’t used to assess platelet refractoriness. Serum ferritin relates to iron storage and overload, not platelet response. Platelet morphology describes shape and appearance but doesn’t measure transfusion effectiveness.