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Increased blood transfusion after outpatient autologous transplantation with reduced intensity conditioning for hematological malignancies predicts worse outcomes
Author(s) -
JaimePérez José Carlos,
HernándezCoronado Marcela,
AncerRodríguez Jesús,
GómezAlmaguer David
Publication year - 2021
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.14247
Subject(s) - medicine , cumulative incidence , hematopoietic stem cell transplantation , packed red blood cells , transplantation , blood transfusion , platelet transfusion , platelet , incidence (geometry) , blood product , ambulatory , surgery , immunology , physics , optics
Transfusion has a recognized immunomodulatory effect, and its role on the outcomes after an ambulatory autologous hematopoietic stem cell transplantation (auto‐HSCT) following reduced intensity conditioning (RIC) has not been documented. A study to assess factors associated with the number of packed red blood cells (PRBCs) and platelet units transfused and their impact on survival rates of auto‐HSCT recipients after RIC was conducted between 2013 and 2019. Transfusions were recorded from days 0 to 100. Of the 130 patients studied, seventy (53.9%) required transfusion support. The median number of PRBC transfused was 2 (range 1‐20), and for platelets, it was also 2 units (range 1‐19). Infused CD34 + cells/kg, pre‐transplant CMV status, and relapse/progression were significantly associated with the number of PRBC units transfused and sex, infused CD34 + cells/kg, and pre‐transplant CMV status with the number of platelet units transfused. In multivariate analysis, a high/very high Disease Risk Index ( P = .001) ( P = .001) and transfusion of ≥ 5 total blood products ( P = .001) ( P = .010) were associated with decreased disease‐free and overall survival. Two‐year cumulative incidence of relapse was 50% for transfused patients vs. 34% for those not transfused ( P = .009). These data suggest that the transfusion burden and its interplay with other patient and transplant‐related factors could be associated with inferior auto‐HSCT outcomes.