Clinical factors affecting engraftment and transfusion needs in SCT: a single-center retrospective analysis

Abstract

Successful utilization of SCT modalities often requires utilization of both red cell and platelet transfusions. In this retrospective evaluation of clinical factors affecting transplant engraftment and transfusion utilization at a single transplant center in 505 patients from 2005 through 2009, we found that graft type, donor type and the conditioning regimen intensity significantly affected both the neutrophil engraftment time (Po0.001) and the platelet engraftment time (Po0.001). SCT patients required an average of 6.2 red cell units, and 7.9 platelet transfusions in the first 100 days with a wide s.d. Among auto-SCT patients, 5% required neither RBC nor platelet transfusions. Some reduced-intensity transplants were also associated with no transfusion need, and in allogeneic transplants, conditioning regimen intensity was positively correlated with platelet transfusion events as assessed by multivariate analysis. Other patient characteristics such as gender, graft type, donor type, underlying disease and use of TBI were all independently associated with transfusion needs in SCT patients. Further studies are required to understand the means to minimize transfusions and potential related complications in SCT patients.

Impact of ABO blood group mismatch in alemtuzumab-based reduced-intensity conditioned haematopoietic SCT

“…We found no significant effect of ABO mismatch on time to neutrophil and PLT engraftment, with a similar median engraftment time to previous HSCT studies. 26,29,42 Our study thus supports the view that the ABO blood group barrier should not be considered prohibitive to transplant.…”

Red blood cell and platelet transfusion support in the first 30 and 100 days after allogeneic hematopoietic cell transplant

“…Multivariable modeling and analyses of a variety of patient baseline and transplant‐related variables showed that some variables had very little to limited effect (such as sex and age), and confirming previous studies, that advanced stage of disease, 3,4 myeloablative conditioning, 7,23,24 ABO incompatibility, 7,25‐27 and very low CD34+ cell doses 5 were associated with increased transfusion requirements, especially during the first 30 days after transplant. PBSC grafts were also confirmed to be associated with decreased transfusion requirements compared to BM and especially UC grafts 3,15,23,24,28 . We also found that myeloid disorders such as MDS and MPN were associated with higher transfusion requirements, whereas lymphomas and nonmalignant disorder had lower transfusion requirement in the first 30 days compared to acute lymphoid or myeloid leukemias.…”

“…PBSC grafts were also confirmed to be associated with decreased transfusion requirements compared to BM and especially UC grafts. 3,15,23,24,28 We also found that myeloid disorders such as MDS and MPN were associated with higher transfusion requirements, whereas lymphomas and nonmalignant disorder had lower transfusion requirement in the first 30 days compared to acute lymphoid or myeloid leukemias.…”

Analysis of Factors that Influence Hematopoietic Recovery in Autologous Transplanted Patients with Hematopoietic Stem Cells from Peripheral Blood

“…The number of transfusions administered was not affected by age, CD34+ cell number infused or graft type. Among autologous transplanted patients, 5% required neither red blood cells, nor platelet transfusions, as well as some patients who received reduced-intensity conditioning [32]. Among the autologous transplanted patients in our study, there was only one patient (1.1%) who didn’t receive any transfusion.…”