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Reducing the red blood cell transfusion threshold from 8·0 g/dl to 7·0 g/dl in acute myeloid leukaemia patients undergoing induction chemotherapy reduces transfusion rates without adversely affecting patient outcome.
Ballo, Olivier; Fleckenstein, Philine; Eladly, Fagr; Kreisel, Eva-Maria; Stratmann, Jan; Seifried, Erhard; Müller, Markus; Serve, Hubert; Bug, Gesine; Bonig, Halvard; Brandts, Christian H; Finkelmeier, Fabian.
Afiliação
  • Ballo O; Department of Medicine, Hematology/Oncology, University Hospital, Goethe University, Frankfurt/Main, Germany.
  • Fleckenstein P; Department of Medicine, Hematology/Oncology, University Hospital, Goethe University, Frankfurt/Main, Germany.
  • Eladly F; Department of Medicine, Hematology/Oncology, University Hospital, Goethe University, Frankfurt/Main, Germany.
  • Kreisel EM; Department of Medicine, Hematology/Oncology, University Hospital, Goethe University, Frankfurt/Main, Germany.
  • Stratmann J; Department of Medicine, Hematology/Oncology, University Hospital, Goethe University, Frankfurt/Main, Germany.
  • Seifried E; Institute of Transfusion Medicine and Immunohematology, German Red Cross Blood Service Baden-Württemberg-Hessen, Goethe University, Frankfurt/Main, Germany.
  • Müller M; Institute of Transfusion Medicine and Immunohematology, German Red Cross Blood Service Baden-Württemberg-Hessen, Goethe University, Frankfurt/Main, Germany.
  • Serve H; Department of Medicine, Hematology/Oncology, University Hospital, Goethe University, Frankfurt/Main, Germany.
  • Bug G; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.
  • Bonig H; Department of Medicine, Hematology/Oncology, University Hospital, Goethe University, Frankfurt/Main, Germany.
  • Brandts CH; Institute of Transfusion Medicine and Immunohematology, German Red Cross Blood Service Baden-Württemberg-Hessen, Goethe University, Frankfurt/Main, Germany.
  • Finkelmeier F; Department of Medicine, Hematology/Oncology, University Hospital, Goethe University, Frankfurt/Main, Germany.
Vox Sang ; 115(7): 570-578, 2020 Oct.
Article em En | MEDLINE | ID: mdl-32342521
ABSTRACT
BACKGROUND AND

OBJECTIVES:

Red blood cell (RBC) transfusions are needed by almost every acute myeloid leukaemia (AML) patient undergoing induction chemotherapy and constitute a cornerstone in supportive measures for cancer patients in general. Randomized controlled trials have shown non-inferiority or even superiority of restrictive transfusion guidelines over liberal transfusion guidelines in specific clinical situations outside of medical oncology. In this study, we analysed whether more restrictive RBC transfusion reduces blood use without affecting hard outcomes. MATERIALS AND

METHODS:

A total of 352 AML patients diagnosed between 2007 and 2018 and undergoing intensive induction chemotherapy were included in this retrospective analysis. In the less restrictive transfusion group, patients received RBC transfusion for haemoglobin levels below 8 g/dl (2007-2014). In the restrictive transfusion group, patients received RBC transfusion for haemoglobin levels below 7 g/dl (2016-2018). Liberal transfusion triggers were never endorsed.

RESULTS:

A total of 268 (76·1%) and 84 (23·9%) AML patients fell into the less restrictive and restrictive transfusion groups, respectively. The less restrictive transfusion group had 1 g/dl higher mean haemoglobin levels, received their first RBC transfusions earlier and needed 1·5 more units of RBC during the hospital stay of induction chemotherapy. Febrile episodes, C-reactive protein levels, admission to the intensive care unit, length of hospital stay as well as response and survival rates did not differ between the two cohorts.

CONCLUSION:

From our retrospective analysis, we conclude that a more restrictive transfusion trigger does not affect important outcomes of AML patients. The opportunity to test possible effects of the more severe anaemia in the restrictive transfusion group on quality of life was missed.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Leucemia Mieloide Aguda / Transfusão de Eritrócitos Tipo de estudo: Clinical_trials / Guideline Limite: Female / Humans / Male / Middle aged Idioma: En Revista: Vox Sang Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Alemanha

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Leucemia Mieloide Aguda / Transfusão de Eritrócitos Tipo de estudo: Clinical_trials / Guideline Limite: Female / Humans / Male / Middle aged Idioma: En Revista: Vox Sang Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Alemanha