Transfusion Support in the First 100 Days of Allogeneic, Matched, Related Hematopoietic Stem Cell Transplant

Export Background: Patients receiving hematopoietic stem-cell transplantation (HSCT) require extensive transfusion support until red blood cell (RBC) and platelet engraftment occurs. The present study was planned to assess the trend of blood component transfusion in the first 100 days of ABO-compatible (ABOc) and ABO-incompatible (ABOi) allogeneic matched, related HSCT. Materials and Methods: This was a prospective study conducted in the department of transfusion medicine at a large tertiary health-care center between 2016 and 2019. Data of component-wise transfusion from the day of transplant to 100 days posttransplant were collected in all allogeneic matched, related peripheral blood HSCT recipients. Results: During the study duration, there were 62 matched, related HSCT. Of these, 38 were ABOc HSCT, and 24 were ABOi HSCT. The mean CD34+ cell dose harvested by apheresis was 7.7 and 6.2 million/kg for ABOc and ABOi categories, respectively. The most common component transfused was platelets (9.15 mean random donor platelet concentrates [RDPCs] units, 4.45 mean single donor platelet concentrates [SDPCs] units issued), followed by red cells (6.9 mean RBC units issued), with fresh frozen plasma (FFP) (3.2 mean FFP units issued) being the least frequently requested component. The mean number of red cells, RDPC, SDPC, and FFP issued for transfusion in the ABOc category were 7.1, 8.7, 5.5, and 2.3, respectively, while it was 6.7, 9.6, 3.4, and 4.1 in ABOi category, respectively. The component-wise difference in the number of units transfused in the first 100 days was not found to be statistically significant (P < 0.05) between the two categories. Conclusions: Contrary to the usual belief that ABOi transplants require more transfusions, the transfusion practices at the present center did not show a significant difference in component-wise transfusions between the two categories. A restrictive transfusion strategy was an important measure in reducing the number of transfusions.