Factors associated with the avoidance of red blood cell transfusion after hematopoietic stem cell transplantation.
Summary of "Factors associated with the avoidance of red blood cell transfusion after hematopoietic stem cell transplantation."
BACKGROUND:
Red blood cell (RBC) transfusion is required frequently for most patients after hematopoietic stem cell transplantation (HSCT). RBC transfusion, however, can be associated with adverse events including transfusion reactions, acquiring transmissible disease, and delayed recovery. Factors associated with avoidance of transfusion are not well documented. STUDY DESIGN AND
METHODS:
Data concerning RBC transfusions between Day 0 and Day +30 were analyzed for patients undergoing HSCT at a single Canadian transplant center between January 2002 and December 2007.
RESULTS:
Of 555 patients undergoing HSCT with complete RBC transfusion data, 59 patients (10.6%) did not require RBC transfusion in the first 30 days after HSCT. Univariate analysis showed no significant difference in age, graft source, donor type, or conditioning regimen between transfused and nontransfused patients. Factors that were significantly associated with avoidance of transfusion included male sex (p = 0.0013), diagnosis, specifically plasma cell dyscrasias (p < 0.0001), early-stage disease (p = 0.006), and higher baseline hemoglobin (Hb) at time of transplant (p < 0.0001). In multivariate analysis, higher pretransplant Hb, male sex, and early-stage disease remained significantly associated with avoidance of RBC transfusion. Pretransplant Hb correlated inversely with the number of RBC transfusions (r = -0.89).
CONCLUSION:
Increased pretransplant Hb, male sex, and early-stage disease are associated with avoidance of RBC transfusion after HSCT. Interventions aimed at improving pretransplant Hb levels require further study.
Affiliation
From the Department of Medicine, University of Ottawa; the Blood & Marrow Transplant Program and Transfusion Medicine, The Ottawa Hospital; and the Clinical Epidemiology Program and Regenerative Medicine Program, Ottawa Hospital Research Institute, Ottawa
Journal Details
This article was published in the following journal.
Name: Transfusion
ISSN: 1537-2995
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22321053
- DOI: http://dx.doi.org/10.1111/j.1537-2995.2011.03552.x
Medical and Biotech [MESH] Definitions
Hemodilution
Reduction of blood viscosity usually by the addition of cell free solutions. Used clinically (1) in states of impaired microcirculation, (2) for replacement of intraoperative blood loss without homologous blood transfusion, and (3) in cardiopulmonary bypass and hypothermia.
Exchange Transfusion, Whole Blood
Repetitive withdrawal of small amounts of blood and replacement with donor blood until a large proportion of the blood volume has been exchanged. Used in treatment of fetal erythroblastosis, hepatic coma, sickle cell anemia, disseminated intravascular coagulation, septicemia, burns, thrombotic thrombopenic purpura, and fulminant malaria.
Blood Transfusion, Intrauterine
In utero transfusion of BLOOD into the FETUS for the treatment of FETAL DISEASES, such as fetal erythroblastosis (ERYTHROBLASTOSIS, FETAL).
Blood Transfusion
The introduction of whole blood or blood component directly into the blood stream. (Dorland, 27th ed)
Blood Transfusion, Autologous
Reinfusion of blood or blood products derived from the patient's own circulation. (Dorland, 27th ed)
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