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An epidemiologic cohort study reviewing the practice of blood product transfusions among a population of pediatric oncology patients
Author(s) -
Lieberman Lani,
Liu Yang,
Portwine Carol,
Barty Rebecca L.,
Heddle Nancy M.
Publication year - 2014
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.12677
Subject(s) - medicine , interquartile range , blood product , pediatric oncology , blood transfusion , cohort , population , pediatrics , transfusion medicine , emergency medicine , intensive care medicine , surgery , cancer , environmental health
Background Despite the high utilization of blood products by pediatric oncology patients, literature in this population remains scarce. The primary objective of this study was to assess red blood cell ( RBC ) and platelet ( PLT ) utilization rates and transfusion thresholds in pediatric oncology patients. The secondary objective was to describe transfusion‐related complications including RBC alloantibody development and transfusion reactions. Study Design and Methods This epidemiologic cohort study involved pediatric oncology patients at a C anadian academic children's hospital between A pril 2002 and D ecember 2011. Demographic, clinical, laboratory, and transfusion variables were collected from the T ransfusion R egistry for U tilization S tatistics and T racking database, a large database that captures more than 50 demographic and clinical variables as well as comprehensive transfusion information and laboratory test results. Results Of 647 pediatric oncology patients, 430 (66%) received a RBC or PLT transfusion or both during this time period. The median transfusion threshold before a RBC and PLT transfusion was a hemoglobin ( Hb ) value of 72 g/ L (interquartile range [ IQR ], 68‐76 g/ L ) and a PLT count of 16 × 10 9 / L ( IQR , 10 × 10 9 ‐23 × 10 9 / L ), respectively. Ninety‐two percent of the issued RBC and PLT products (7507/8154) were cytomegalovirus negative and 90% were irradiated (7299/8154). RBC alloantibody development and transfusion reactions were reported infrequently in 0.5% (2/423) and 4.5% (8/179) of the patients, respectively. Conclusion This study assessed utilization rates, transfusion thresholds, alloantibody development, and transfusion reactions in pediatric oncology patients. The descriptive results from this epidemiologic study provide baseline information to generate hypotheses to be tested in future interventional studies.