An analysis of transfusion support in haematopoietic stem cell transplantation – report from a centre in India

Datta, Suvro Sankha; Basu, Sabita; Chandy, Mammen

doi:10.1016/j.transci.2015.07.006

Cited by 9 publications

(15 citation statements)

References 18 publications

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“…To our knowledge, this is the first study comparing blood product transfusion requirements in patients who receive a cord blood or haploidentical peripheral blood stem cells. Our results demonstrate, as previously shown in scarce studies, that both UCBT and haplo-HSCT have higher transfusion requirements than those reported for standard HLA-matched HSCT, 10,11,[15][16][17][18][19][20] modalities. However, it should be emphasized that more days are required to reach platelet transfusion independence in the UCBT group.…”

Section: Discussionsupporting

confidence: 89%

Comparison of transfusion requirements in adult patients undergoing Haploidentical or single‐unit umbilical cord blood stem cell transplantation

Solves

Sanz

Gómez

et al. 2019

European J of Haematology

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Objectives: Umbilical cord blood transplantation (UCBT) and haploidentical hematopoietic stem cell transplantation (haplo-HSCT) modalities have been developed to offset the lack of matched donors. In this study, we compare the transfusion requirements of patients undergoing UCBT and haplo-HSCT in a single institution with the aim of providing additional information for clinicians to choose the most adequate alternative graft for HSCT. Methods:The study reviewed 67 and 46 patients undergoing UCBT and haplo-HSCT, respectively.Results: There were no significant differences for RBC and PLT requirements according to the transplantation modality. Median time to RBC transfusion independence was 35 and 25.5 days in patients who received an UCBT and haplo-HSCT, respectively (P = 0.38), while median time to platelet transfusion independence was 31 days for UCBT patients and 23 for haplo-HSCT patients (P < 0.001). Days until neutrophils > 0.5 × 10 9 /L were the only variable that significantly influenced RBC and PLT requirements for both transplantation modalities. Cumulative incidence of RBC and PLT transfusion independence at 90 days after transplantation was similar for both UCBT and haplo-HSCT. Conclusions: Both transplantation platforms require prolonged and intensive supportive RBC and PLT transfusion therapy. Both transplantation platforms require prolonged and intensive supportive RBC and PLT transfusion therapy. K E Y W O R D S haploidentical, stem cell transplantation, transfusion | 173 SOLVES Et aL.

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Section: Discussionsupporting

confidence: 89%

Comparison of transfusion requirements in adult patients undergoing Haploidentical or single‐unit umbilical cord blood stem cell transplantation

Solves

Sanz

Gómez

et al. 2019

European J of Haematology

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“…However, quantitative data on the transfusion requirements and determinants of increased transfusion support are scarce for haplo-HSCT recipients, as most centers have only begun to perform haplo-HSCTs in significant numbers. Previously published studies have suggested that they required more transfusions than MUD, MRD, and autologous transplant recipients, 30,31 but they were based on only a handful of haplo-HSCT recipients. To our knowledge, this is the first retrospective study examining the transfusion needs of a large group of haplo-HSCT recipients.…”

Section: Discussionmentioning

confidence: 99%

“…The median number of days to achieve RBC and platelet transfusion independence were 34 days (95% confidence interval, or 95% CI: [28][29][30][31][32][33][34][35][36][37][38][39][40] independence, and 89.5% (95% CI: 83.5%-93.4%) had achieved platelet independence ( Table 2, and Fig. 1A and B).…”

Section: Transfusion Independencementioning

confidence: 99%

“…Among the transfused patients, medians of 5 units (interquartile range [IQR] = 3-8) of RBCs and 11 units (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) platelets were given in the first 30 days, and medians of 3 units (IQR = 1-7) of RBCs and 6 units (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) of platelets were transfused between days 31 and 100. Median times for achieving RBC and platelet transfusion independence were 34 (95% CI: [28][29][30][31][32][33][34][35][36][37][38][39][40]) and 25 (95% CI: 23-27) days, respectively. Multivariable analyses showed that RBC transfusions in the 10 days before HSCT were associated with significantly increased and sustained RBC and platelet transfusion requirements.…”

mentioning

confidence: 99%

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RBC and platelet transfusion support in the first 30 and 100 days after haploidentical hematopoietic stem cell transplantation

et al. 2019

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BACKGROUND The volume of haploidentical hematopoietic stem cell transplant (haplo‐HSCT) has increased dramatically in recent years. However, the associated higher risk of delayed engraftment may increase patient transfusion requirements. STUDY DESIGN AND METHODS The post‐HSCT RBC and platelet transfusions of 195 haplo‐HSCT recipients were evaluated. Patient and transplant‐related factors potentially impacting the number of products transfused and time to transfusion independence were assessed. RESULTS Nearly all (98.4%) patients were transfused in the first 30 days, and 59.2% were transfused between days 31 and 100. Among the transfused patients, medians of 5 units (interquartile range [IQR] = 3‐8) of RBCs and 11 units (6‐20) platelets were given in the first 30 days, and medians of 3 units (IQR = 1‐7) of RBCs and 6 units (2‐18) of platelets were transfused between days 31 and 100. Median times for achieving RBC and platelet transfusion independence were 34 (95% CI: 28‐40) and 25 (95% CI: 23‐27) days, respectively. Multivariable analyses showed that RBC transfusions in the 10 days before HSCT were associated with significantly increased and sustained RBC and platelet transfusion requirements. Major ABO incompatibility led to increased RBC transfusions. Advanced disease was associated with increased transfusions during the first 30 days, whereas GVHD increased platelet transfusions between days 31 and 100. Effects of age, sex, CD34+ cell dose, stem cell source, and conditioning regimen were limited or insignificant. CONCLUSIONS This study for the first time provided quantitative transfusion data on a large cohort of haplo‐HSCT recipients and identified factors predictive of increased transfusions.

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“…HSCT transplants for Phase I/II clinical trials conducted from 1993 through 2010 at a single center. While several reports [28][29][30][31][32][33][34][35][36][37][38][39] (Table S5, available as supporting information in the online version of this paper) have examined one or more of the factors that we studied, we have been able to undertake a series of analyses to determine the relative importance of these variables. We include transplants performed continuously over many years, a variety of transplant practices, a substantial number of subjects, and extended follow-up.…”

Section: Discussionmentioning

confidence: 99%

Transfusion support for matched sibling allogeneic hematopoietic stem cell transplantation (1993–2010): factors that predict intensity and time to transfusion independence

et al. 2018

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Background: Patients undergoing allogeneic hematopoietic stem cell transplant (HCT) require variable, often extensive transfusion support. Identification of factors that predict urgent, intensive, or special needs should improve management of these patients. Study Design and Methods: This is a retrospective study of red blood cell (RBC) and platelet transfusion support provided for sequential matched sibling donor (MSD) allogeneic transplants conducted at the Clinical Center, NIH, from 1993-2010. Factors potentially important for predicting quantity of RBC and platelet transfusions, and time to transfusion independence through Day 200 post-HCT were evaluated. Results: Subjects (n=800) received 10,591 RBC and 10,199 platelet transfusions. Multivariable analysis demonstrated that need for RBC pretransplant, CD34+ dose, transplant year, diagnostic category, and ABO match were significantly independently associated with quantity of RBC transfusions Days 0-30. Only pretransplant need for RBC, CD34+ dose and transplant year had significance during Days 0-100. Similar analyses for quantity of platelet transfusions demonstrated that for both Days 0-30 and 0-100, significant factors were need for platelet support pretransplant, CD34+ dose, transplant year, and transplant regimen. Of note, long term, during Days 101-200, only CD34+ dose remained significant for quantity of RBC and of platelet transfusions. Analysis of time to transfusion independence demonstrated that patients with ABO major mismatches required longer to achieve freedom from RBC transfusion support compared to identical matches or those with minor mismatches. Conclusion: Patient-specific factors including CD34+ dose and ABO match of the graft should be given particular consideration by transfusion services when planning support of patients receiving allogeneic HCT.

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An analysis of transfusion support in haematopoietic stem cell transplantation – report from a centre in India

Cited by 9 publications

References 18 publications

Comparison of transfusion requirements in adult patients undergoing Haploidentical or single‐unit umbilical cord blood stem cell transplantation

Comparison of transfusion requirements in adult patients undergoing Haploidentical or single‐unit umbilical cord blood stem cell transplantation

RBC and platelet transfusion support in the first 30 and 100 days after haploidentical hematopoietic stem cell transplantation

Transfusion support for matched sibling allogeneic hematopoietic stem cell transplantation (1993–2010): factors that predict intensity and time to transfusion independence

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