Audit of red blood cell transfusion in patients with acute leukemia at a tertiary care university hospital

Jaime‐Pérez, José Carlos; García-Salas, Gerardo; Áncer‐Rodríguez, Jesús; Gómez‐Almaguer, David

doi:10.1111/trf.15700

Cited by 4 publications

(4 citation statements)

References 23 publications

(55 reference statements)

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“…It is mainly divided into two types: acute lymphoblastic leukemia and acute myeloid leukemia [ 1 ], and the mortality is high in malignancies [ 2 ]. To prevent thrombocytopenia or bleeding, blood transfusion therapy is one of the supportive care measures for leukemia patients following cytotoxic chemotherapy [ 3 , 4 ]. However, during blood transfusion therapy, the body is stimulated to produce anti-platelet-associated antibodies due to the immune effect of leukocytes in blood products, affecting the effect of platelet transfusion, resulting in no significant increase in platelet count, bleeding symptoms are not significantly controlled, fever, allergy, and other adverse reactions may also occur, and intracranial hemorrhage may also be caused in severe cases [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

The Analysis of the Effect of Blood Transfusion on Changes of Blood Platelet Parameters in Patients with Leukemia Treated with Chemotherapy

Liang

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Objective. To study and analyze the effect of blood transfusion on the change of blood platelet parameters in patients with leukemia treated with chemotherapy. Methods. Ninety-eight patients with leukemia treated with chemotherapy in the First Affiliated Hospital of Xi’an Jiaotong University from January 2021 to January 2022 were selected to observe the changes of platelet parameters before and after blood transfusion. Results. There was significant difference between pre-transfusion and post-transfusion indexes (platelet count, mean platelet volume, and hematocrit) ( P < 0.05 ). After binary logistic regression analysis, the use of antibiotics (OR = 2.235), blood transfusion history (OR = 3.086), abnormal white blood cell count (OR = 1.134), and frozen plasma transfusion (OR = 3.121) were the main factors of blood platelet parameters after transfusion in leukemia patients ( P < 0.05 ). Conclusion. Blood transfusion is beneficial to improve blood platelet parameters and prevent bleeding in patients with leukemia treated with chemotherapy. Attention should be paid to patients with risk factors for poor response to blood platelet transfusion and early intervention.

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Section: Introductionmentioning

confidence: 99%

The Analysis of the Effect of Blood Transfusion on Changes of Blood Platelet Parameters in Patients with Leukemia Treated with Chemotherapy

Liang

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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“…Our apheresis unit is dedicated to the needs of patients with hematological diseases, including those receiving a hematopoietic cell transplant. 15 The units collected in our service are transfused in this hospital according to guidelines 13,16 within the next 24 hours of collection.…”

Section: Methodsmentioning

confidence: 99%

Assessing the performance of a plateletpheresis unit at a tertiary‐care academic medical center in Mexico: A 6‐year experience

Jaime‐Pérez

Beltrán-López

Alvarado-Navarro

et al. 2021

J of Clinical Apheresis

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BackgroundOptimization of platelet (PLT) apheresis collection is a priority to satisfy the increasing demand of hemato‐oncology patients. We assessed the performance of a plateletpheresis unit supporting hematology patients.Study design and methodsThis descriptive retrospective study included 561 plateletpheresis collections from 2013 to 2018. For data analysis, descriptive statistics and receiver operating characteristic (ROC) curve were used. A 5‐item satisfaction questionnaire was analyzed.ResultsNinety percent of the donors were males. The median plateletpheresis time was 89 minutes; its success rate was 92.5%; median donor PLT count was 232 × 109/L, women median PLT count was 247 × 109/L vs 231x109/L in men (P = .017). Seventy‐seven percent donors were candidates for a double product and 24.5% were processed; 20.8% of these donors had a weight ≤75 and 79.2% >75 kg, P = .003, and 6.6% were women and 93.4% men, P = .161. Thirty‐six of donors had ≥250 × 109/L and 16.8% was processed as a triple product. ROC analysis showed that with donor PLT counts ≥200 × 109/L the sensitivity for obtaining double products was 0.981 and specificity 0.714, with an area under the curve (AUC) = 0.877. The adverse effect rate was 4.3%. Of the potential donors, 6.3% were rejected. The cost of processing single or double products was 430 USD. Comfort and time spent during plateletpheresis were areas for improvement.ConclusionPlatelet count and donor weight predicted PLT yield and obtaining double products. Women had higher PLT counts, but no significant difference was found between donor gender and processed products. Assessment of the apheresis unit can help to improve its performance.

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“…However, inappropriate use of platelets is common (6%–49%) and may have multiple reasons. Inadequate physician training may be an important reason 5‐8 . Overuse of platelets increases the risk of transfusion reactions, platelet refractoriness, transfusion‐transmitted infections, and the non‐availability of this scarce resource when it is essential.…”

Section: Introductionmentioning

confidence: 99%

“…Inadequate physician training may be an important reason. [5][6][7][8] Overuse of platelets increases the risk of transfusion reactions, platelet refractoriness, transfusion-transmitted infections, and the nonavailability of this scarce resource when it is essential. During the Covid-19 pandemic and subsequent lockdowns, there was an acute shortage of blood products, mainly due to the non-availability of donors.…”

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confidence: 99%

Optimising platelet usage during the induction therapy of acute myeloid leukaemia: Impact of physician education

Gnanaraj

Basavarajegowda

Kayal

et al. 2023

Transfusion Medicine

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Introduction Platelet products are scarce and expensive resources to be used judiciously. However, inappropriate usage is common. Lack of physician awareness is an important issue. We implemented a physician education program (PEP) along with repeated WhatsApp reminders at our centre. We audited the platelet usage practise before and after the intervention. Methods Charts of patients with acute myeloid leukaemia (AML) treated between January 2020 and August 2020 was reviewed, and the mean platelet usage per patient per day was calculated. Physician education was implemented between September 2020 and December 2020 (2 PowerPoint lectures of 20 min each and weekly WhatsApp messages containing the guidelines). Data of patients treated between Jan 2021 and August 2021 was prospectively audited to understand platelet usage and the indications for transfusions. The British Committee for the Standards in Haematology (BCSH) platelet transfusion guidelines were used as the adjudication tool to evaluate compliance. The mean platelet usage per day per kg body weight of a patient before and after the PEP was compared using the t‐test. Results Group A (before physician education) consisted of 22 patients, and group B (after physician education) consisted of 23 patients. The mean number of platelet transfusions for each patient in a day per kg body weight was 125.7 × 108 in group A whereas, after the PEP, it had reduced to 73.9 × 108 amounting to an absolute reduction of 51 × 108 (58.8%) from the baseline with a statistical significance of P = 0.001. After implementing the PEP, the mean number of random donor platelets used reduced by 10.25 units (34% reduction), and the mean single donor platelets used reduced by 0.83 units (19% reduction). The 190 requests for platelet transfusion received during this period were classified as appropriate (157/190), which constituted 82.63% of the requests, or inappropriate (33/190), which accounted for 17.36%. Conclusions A short‐duration education programme supplemented with weekly WhatsApp messages and an active feedback mechanism on the rationale of platelet transfusion by the treating physician and transfusion specialist could significantly reduce platelet consumption during the therapy of acute myeloid leukaemia patients. This is a measure that can be considered by all high‐volume haematology centres, which can improve patient safety and reduce costs.

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Audit of red blood cell transfusion in patients with acute leukemia at a tertiary care university hospital

Cited by 4 publications

References 23 publications

The Analysis of the Effect of Blood Transfusion on Changes of Blood Platelet Parameters in Patients with Leukemia Treated with Chemotherapy

The Analysis of the Effect of Blood Transfusion on Changes of Blood Platelet Parameters in Patients with Leukemia Treated with Chemotherapy

Assessing the performance of a plateletpheresis unit at a tertiary‐care academic medical center in Mexico: A 6‐year experience

Optimising platelet usage during the induction therapy of acute myeloid leukaemia: Impact of physician education

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