title: Blood transfusion in hematologic intensive care unit.
abstract: There is increasing evidence that excessive blood transfusion may be associated with impaired survival or cardiovascular events. One way to reduce the number of red blood cells (RBCs) is to transfuse 1 unit (1RBC) instead of 2 units of RBCs (2RBC).
  
  
  
  Patients requiring blood transfusions in hematologic intensive care unit were included in a prospective study using a single RBC unit per transfusion and were compared with an historical cohort who received 2 RBC units per transfusion.
  
  
  
  A total of 1323 units were transfused to 126 patients between 2013 and 2014. The 186 patients in the comparative cohort received a total of 1824 RBC units in a 2-RBC-unit policy between 2010 and 2012. The mean number of units was 7.35 (SD, 5.9 units; 95% confidence interval [CI], 6.5-8.2 units) in the 1RBC group and 8.14 units (SD, 6.2 units; 95% CI, 7.3-8.9 units) in the 2RBC group. The absolute mean difference was -0.79 (95% CI, -1.98 to 0.40; p = 0.09). In the 1RBC allogeneic hematopoietic stem cell transplantation (allo-HSCT) subgroup, a significant reduction in the number of RBC units transfused was observed in comparison with the historical 2RBC allo-HSCT group (5 units vs. 7.7 units; p = 0.01). No anemia-related side effects were reported. Overall survival did not differ between the two groups.
  
  
  
  The 1RBC transfusion policy made is feasible in patients with transient hematologic toxicity after chemotherapy. The number of units transfused between the two groups was not different. However, in the allo-HSCT group, the use of a single RBC unit reduced significantly RBC consumption. A randomized trial comparing the two strategies is planned with a medicoeconomic evaluation.
authors.affiliation: Department of Hematology, Medical School, Caen.
authors.forename: Sylvain P
authors.initials: SP
authors.lastname: Chantepie
authors.affiliation: Department of Hematology, Medical School, Caen.
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Mear
authors.affiliation: Department of Biostatistics and Clinical Research, Medical School, Caen.|Université Caen Normandie, Medical School, Caen, France.
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Parienti
authors.affiliation: Department of Hemovigilance, CHU de Caen.
authors.forename: Agnès
authors.initials: A
authors.lastname: Bazin
authors.affiliation: Department of Hematology, Medical School, Caen.
authors.forename: Khaled
authors.initials: K
authors.lastname: Benabed
authors.affiliation: Department of Hematology, Medical School, Caen.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Cheze
authors.affiliation: Department of Hematology, Medical School, Caen.
authors.forename: Anne-Claire
authors.initials: AC
authors.lastname: Gac
authors.affiliation: Department of Hematology, Medical School, Caen.
authors.forename: Hyacinthe
authors.initials: H
authors.lastname: Johnson-Ansah
authors.affiliation: Department of Hematology, Medical School, Caen.
authors.forename: Margaret
authors.initials: M
authors.lastname: Macro
authors.affiliation: Department of Hematology, CHU Sud Réunion, Saint Pierre, France.
authors.forename: Quentin
authors.initials: Q
authors.lastname: Cabrera
authors.affiliation: Department of Hematology, Medical School, Caen.
authors.forename: Emilie
authors.initials: E
authors.lastname: Reboursiere
authors.affiliation: Department of Hematology, Medical School, Caen.
authors.forename: Charles
authors.initials: C
authors.lastname: Lancesseur
authors.affiliation: Department of Hematology, Medical School, Caen.|Université Caen Normandie, Medical School, Caen, France.
authors.forename: Gandhi
authors.initials: G
authors.lastname: Damaj
authors.affiliation: Department of Hematology, Medical School, Caen.
authors.forename: Oumedaly
authors.initials: O
authors.lastname: Reman
mesh_terms: D000328:Adult; D000368:Aged; D003422:Critical Care / Q000379:methods*; D018572:Disease-Free Survival; D017707:Erythrocyte Transfusion; D005260:Female; D019337:Hematologic Neoplasms / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015996:Survival Rate