Factors associated with the avoidance of red blood cell transfusion after hematopoietic stem cell transplantation.
BACKGROUND
Red blood cell (RBC) transfusion is required frequently for most patients after hematopoietic stem cell transplantation (HSCT). RBC transfusion, however, can be associated with adverse events including transfusion reactions, acquiring transmissible disease, and delayed recovery. Factors associated with avoidance of transfusion are not well documented.


METHODS
Data concerning RBC transfusions between Day 0 and Day +30 were analyzed for patients undergoing HSCT at a single Canadian transplant center between January 2002 and December 2007.


RESULTS
Of 555 patients undergoing HSCT with complete RBC transfusion data, 59 patients (10.6%) did not require RBC transfusion in the first 30 days after HSCT. Univariate analysis showed no significant difference in age, graft source, donor type, or conditioning regimen between transfused and nontransfused patients. Factors that were significantly associated with avoidance of transfusion included male sex (p = 0.0013), diagnosis, specifically plasma cell dyscrasias (p < 0.0001), early-stage disease (p = 0.006), and higher baseline hemoglobin (Hb) at time of transplant (p < 0.0001). In multivariate analysis, higher pretransplant Hb, male sex, and early-stage disease remained significantly associated with avoidance of RBC transfusion. Pretransplant Hb correlated inversely with the number of RBC transfusions (r = -0.89).


CONCLUSIONS
Increased pretransplant Hb, male sex, and early-stage disease are associated with avoidance of RBC transfusion after HSCT. Interventions aimed at improving pretransplant Hb levels require further study.
Department of Medicine, University of Ottawa, Ontario, Canada.
Natasha
N
Kekre
Grace
G
Christou
Ranjeeta
R
Mallick
Melanie
M
Tokessy
Alan
A
Tinmouth
Jason
J
Tay
David S
DS
Allan
D000328:Adult; D001787:Blood Group Incompatibility / Q000453:epidemiology; D015984:Causality; D017707:Erythrocyte Transfusion / Q000706:statistics & numerical data*; D005260:Female; D019337:Hematologic Neoplasms / Q000097:blood / Q000453:epidemiology* / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000706:statistics & numerical data*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D019172:Transplantation Conditioning / Q000379:methods / Q000706:statistics & numerical data
D006454:Hemoglobins