Assessing Safety of Pneumatic Tube System (PTS) for Patients with Very Low Hematologic Parameters.
BACKGROUND Preventive interventions save lives during the process of chemotherapy for hematologic malignancies, when a hematology laboratory can ensure accurate results. The use of a pneumatic tube system (PTS) is associated with measurement errors and unnecessary transfusions. The aim of this study was to evaluate pre-analytical errors associated with transportation method (PTS versus hand-delivered) and to investigate whether there are unnecessary transfusion events in pancytopenia leukemia patients with very low hematological parameters. MATERIAL AND METHODS A total of 140 paired blood collections were performed for hemogram and biochemistry assays. Paired EDTA and serum gel blood samples were collected from 58 cases with acute leukemia on different days. For each pair, one sample was hand-delivered by a courier (Group 1) while the other sample was transported through a PTS (Group 2). RESULTS The hand-delivered method showed that some platelet transfusions were unnecessary for different thrombocyte cut-off values. Calculated unnecessary platelet (PLT) transfusion ratios when using PTS (PLT <30×10³/µL, 16.3%; PLT <25×10³/µL, 16.4%; PLT <20×10³/µL, 80.3%; PLT <15×10³/µL, 48.6%; and PLT <10×10³/µL, 150.0%) were found to be statistically significant (p=0.002, p=0.046, p<0.000, p=0.028, and p<0.000, respectively). In contrast, for RBC transfusion ratios, although the ratios were high in Group 2, we found no significant difference between the two groups; (HGB <8.0 g/dL, 23.3%; HGB <9.0 g/dL, 25.0%, HGB<10.0 g/dL, 19.3%) and (p=0.002, p=0.085, p<0.160, and p=0.235, respectively). CONCLUSIONS Although our results cannot be universally applied, physicians should be careful, skeptical, and suspicious of transfusion decisions in hematology clinics and consider potential analytical and pre-analytical errors in cases of severe cytopenia when using PTS.
Department of Hematology, Karabuk University, Faculty of Medicine, Karabuk, Turkey.
Mustafa
M
Koroglu
Department of Hematology, Inonu University, Faculty of Medicine, Malatya, Turkey.
Mehmet Ali
MA
Erkurt
Department of Hematology, Inonu University, Faculty of Medicine, Malatya, Turkey.
Irfan
I
Kuku
Department of Hematology, Inonu University, Faculty of Medicine, Malatya, Turkey.
Emin
E
Kaya
Department of Hematology, Inonu University, Faculty of Medicine, Malatya, Turkey.
Ilhami
I
Berber
Department of Hematology, Inonu University, Faculty of Medicine, Malatya, Turkey.
Ilknur
I
Nizam
Department of Hematology, Inonu University, Faculty of Medicine, Malatya, Turkey.
Yavuz
Y
Yagar
Department of Biostatistics, Karabuk University, Faculty of Medicine, Karabuk, Turkey.
Seyit Ali
SA
Kayis
D000328:Adult; D001774:Blood Chemical Analysis; D005260:Female; D006405:Hematology / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017713:Platelet Transfusion / Q000009:adverse effects* / Q000295:instrumentation*