1.
Comparison of transfusion requirements in adult patients undergoing haploidentical or single unit umbilical cord blood stem cell transplantation
Solves, P., Sanz, J., Gomez, I., de la Puerta, R., Arnao, M., Montoro, J., Pinana, J. L., Carretero, C., Balaguer, A., Guerreiro, M., et al
European journal of haematology. 2019
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Editor's Choice
Abstract
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 days 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 x 10(9) /L was 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. This article is protected by copyright. All rights reserved.
PICO Summary
Population
Patients undergoing allogeneic transplantation from different donor sources had their transfusion requirements monitored.
Intervention
Umbilical cord blood transplantation (n=67)
Comparison
Haploidentical transplantation (n=46)
Outcome
There were no significant differences for RBC and PLT requirements according to the transplantation modality. Days until neutrophils > 0.5 x 10(9) /L was 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.
2.
Red blood cell transfusion burden by day 30 predicts mortality in adults after single-unit cord blood transplantation
Konuma, T., Oiwa-Monna, M., Mizusawa, M., Isobe, M., Kato, S., Nagamura-Inoue, T., Takahashi, S., Tojo, A.
Bone marrow transplantation. 2019
Abstract
Increased red blood cell (RBC) transfusion requirements are associated with morbidity and mortality after allogeneic hematopoietic cell transplantation. However, its impact on the outcomes after cord blood transplantation (CBT) is unclear. We retrospectively analyzed the data of 278 adult patients who received single-unit CBT in our institute. The median number of RBC transfusions for each patient was 12 units (range, 4-66) by day 30 and 14 units (range, 4-70) by RBC engraftment. Sex, cord blood CD34(+) cell dose, cytomegalovirus serostatus, total body irradiation dose in the conditioning regimen, ABO blood group incompatibility, and pre-CBT RBC transfusion requirements were significantly associated with the number of RBC transfusion units in the linear regression analysis. In the multivariate analysis, RBC transfusion ≥18 units by day 30 was significantly associated with higher overall mortality (hazard ratio, 1.86; P = 0.018). These data suggested that early RBC transfusion burden was significantly associated with overall mortality in adult patients undergoing single CBT. Early RBC transfusion burden might be a surrogate marker for poor outcomes after single CBT.