Abstract

Of 435 consecutive patients with acute leukemia, 95 patients had 167 operations with a platelet count of < 100 × 10⁹/L and 130 operations with platelet counts of < 50 × 10⁹/L. Only 7% of operations had intraoperative blood loss of >500 ml, and 7% required >4 units of red cells transfused in the perioperative period. No patient died of bleeding attributable to surgery within 1 month of the operation. Granulocyte count was 500 ml and/or perioperative red blood cell RBC transfusions >4 units (P < .001). Surgery in cytopenic patients with acute leukemia is safe provided optimal supportive care is available.