Single vs Double-Unit Transfusion in Patients With Hematological Disorders Undergoing Chemotherapy or Stem Cell Transplantation: A Systematic Review And Meta-Analysis

Abstract

There is no consensus to support the single unit-transfusion policy (1-RBC) over the double-unit transfusion policy (2-RBC) in patients with hematological disorders undergoing chemotherapy or stem cell transplantation. We searched PubMed, Embase, and Cochrane Library. Risk ratios (RR) and mean differences (MD) were pooled. Statistical analysis was performed using Review Manager and R software. Heterogeneity was assessed using I² statistics. Hemoglobin (Hb) levels at discharge (MD −0.41 g/dL; 95% CI −0.53, −0.29 g/dL; P < .01) and total RBC units used per admission (MD −0.82 units; 95% CI −1.60, -0.05 units; P = .04) were significantly lower in patients who received 1-RBC, while length of hospital stay (MD 0.05 days; 95% CI −0.29, 0.39 days; P = .89), severe bleeding (RR 1.52; 95% CI 0.85, 2.71; P = .16) and mortality (RR 0.89; 95% CI 0.52, 1.53; P = .69) showed no significant difference between groups. In patients with hematological disorders undergoing chemotherapy or stem cell transplantation, 1-RBC is associated with lower Hb levels at discharge and a reduction in the total number of RBC units used per admission, with no significant difference in terms of length of hospital stay, severe bleeding risk, transfusion-related adverse events and mortality.