ASH-ASPHO Task Force Questions 5 Pediatric Hematology Tests and Treatments

A joint task force formed by the American Society of Hematology (ASH) and the American Society of Pediatric Hematology/Oncology (ASPHO) have created a pediatric-focused list for Choosing Wisely, a medical stewardship and quality improvement collaboration by the American Board of Internal Medicine Foundation and medical societies in the United States.

The ASH-ASPHO task force identified 5 tests and treatments that are not supported by evidence and/or are financially and clinically risky while not likely to be beneficial for patients. The task force recommends that providers caring for pediatric patients with hematologic disorders carefully consider the risks and benefits of these procedures before performing them.

The recommendations are as follows:

• Avoid routine preoperative hemostatic testing in an otherwise healthy child with no previous personal or family history of bleeding.
• Avoid platelet transfusion in asymptomatic children with a platelet count >10×10⁹/L unless an invasive procedure is planned.
• Avoid thrombophilia testing in children with venous access-associated thrombosis and no positive family history.
• Avoid packed red blood cells transfusion for asymptomatic children with iron-deficiency anemia and no active bleeding.
• Avoid routine administration of granulocyte colony-stimulating factor for prophylaxis of children with asymptomatic autoimmune neutropenia and no history of recurrent or severe infections.

Source: Blood Advances