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Thrombosis Risk in Cancer Patients Receiving Red Blood Cell Transfusions.
Ramsey, Glenn; Lindholm, Paul F.
Affiliation
  • Ramsey G; Department of Pathology, Blood Bank, Northwestern Memorial Hospital, Chicago, Illinois.
  • Lindholm PF; Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Semin Thromb Hemost ; 45(6): 648-656, 2019 Sep.
Article in En | MEDLINE | ID: mdl-31430787
ABSTRACT
Patients with cancer have increased risk of thrombosis and often need red blood cell (RBC) transfusions. However, RBC transfusions may also promote thrombosis because of raised hematocrit and viscosity, storage-related RBC damage, and exposure to thrombogenic mediators from obsolescent RBCs. The authors conducted a literature survey for studies examining whether RBC transfusions were associated with increased risk of venous thromboembolism (VTE) in cancer patients. In perioperative cancer surgery patients with categorical comparisons of any versus no RBC transfusion, increased risk of VTE with RBC transfusion was found in 11 of 31 studies, 5 by univariate correlation only and 6 in multivariate analysis. All six multivariate-positive studies had intermediate overall rates of thrombosis (1.4-6.0%), and three were in urological surgery series. In the larger studies of > 2,000 patients (range 2,219-44,656), the maximum odds ratio among the multivariate-positive studies was 1.3. Perioperative RBC transfusion volume was more strongly associated with VTE risk, with a positive association in six of seven studies. One large registry-based study of hospitalized cancer patients, not restricted to the perioperative setting, found an adjusted odds ratio of 1.60 (95% confidence interval 1.53-1.67) for VTE risk in patients receiving RBCs compared with nontransfused patients.
Subject(s)

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Thrombosis / Blood Transfusion / Transfusion Reaction Type of study: Etiology_studies / Risk_factors_studies Limits: Female / Humans / Male Language: En Journal: Semin Thromb Hemost Year: 2019 Document type: Article

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Thrombosis / Blood Transfusion / Transfusion Reaction Type of study: Etiology_studies / Risk_factors_studies Limits: Female / Humans / Male Language: En Journal: Semin Thromb Hemost Year: 2019 Document type: Article