Cryoprecipitate utilization review in light of recent guidelines: a single-center prospective analysis of haemato-oncology patients.

Background: Cryoprecipitate, a cost-effective fibrinogen replacement, remains vital in managing coagulopathies, particularly in resource-limited settings. There is a wide variation of cryoprecipitate transfusion practices worldwide, even though it is widely transfused in various clinical settings.

Study design and methods: This prospective observational study investigated cryoprecipitate utilization patterns in a tertiary care center in Northern India, focusing on Haemato-Oncology patients. This study was conducted over a period of one year, analyzing 350 transfusion events across 286 patients. Data on patient demographics, clinical and laboratory parameters, and transfusion indications were collected and evaluated for adherence to established guidelines.

Results: Cryoprecipitate accounted for 2.1 % of blood component requests, predominantly from the Haemato-Oncology department (73 %). Among the transfusion events, 65.7 % were deemed appropriate based on guidelines, with the majority (85.6 %) occurring in Haemato-Oncology patients. Pre- and post-transfusion fibrinogen levels were documented in 45.4 % of events, revealing a mean fibrinogen increase of 0.71 g/L per dose. However, 34.3 % of events were inappropriate, largely due to transfusions without pre-transfusion fibrinogen measurements.

Discussion: Key findings include hypofibrinogenemia as the leading indication for cryoprecipitate transfusion (74.3%) and significant differences in transfusion practices between Haemato-Oncology and non-Haemato-Oncology population cohorts. The study highlights the need for periodic utilization audits and continuous training of stakeholders to ensure adherence to evidence-based guidelines and reduce empirical transfusion practices. Future multi-center studies are recommended to establish standardized cryoprecipitate administration protocols and assess clinical outcomes.