Red blood cell transfusions for thalassemia: results of a survey assessing current practice and proposal of evidence‐based guidelines. Issue 7 (24th February 2014)

• Record Type: Journal Article
• Authors: Goss, Cheryl; Giardina, Patricia; Degtyaryova, Diana; Kleinert, Dorothy; Sheth, Sujit; Cushing, Melissa
• Is Part Of: Transfusion. Volume 54:Issue 7(2014)
• Page Start: 1773
• Page End: 1781
• Publication Date: 2014-02-24
• Subjects: Hematology -- Periodicals; Blood -- Transfusion -- Periodicals; Blood Group Antigens -- Periodicals; Blood Preservation -- Periodicals; Blood Transfusion -- Periodicals; 615
• DOI: 10.1111/trf.12571
• Languages: English
• ISSNs: 0041-1132

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="trf12571-sec-0001" sec-type="section"> <title>Background</title> <p>In the absence of curative treatment, such as stem cell transplant, regular transfusions remain the mainstay of therapy for individuals with thalassemia major, a syndrome that results from marked ineffective erythropoiesis and the resultant anemia. The primary objectives of transfusion therapy are twofold: to suppress ineffective erythropoiesis and to ensure appropriate growth and development through childhood. In practice, a number of different transfusion protocols are in use across the developed world, with on‐demand transfusion still being the paradigm in most of the developing world with limited resources.</p> </sec> <sec id="trf12571-sec-0002" sec-type="section"> <title>Study Design and Methods</title> <p>To investigate perceived differences in transfusion practice, a self‐reported electronic survey was disseminated to eight US thalassemia treatment centers in February 2011. The survey was divided into sections ranging from laboratory and clinical practices to emerging transfusion‐transmitted diseases.</p> </sec> <sec id="trf12571-sec-0003" sec-type="section"> <title>Results</title> <p>The survey response rate was 100%. The total number of transfused patients was 411. One‐hundred percent of institutions used leukoreduced blood. No centers routinely provided cytomegalovirus‐seronegative red blood cells (RBCs). Half the centers provided irradiated RBCs; only one routinely provided washed RBCs, and none transfused RBCs of defined storage age. Seventy‐five percent of centers routinely phenotyped thalassemia patients' RBC antigens; 50% prophylactically matched for Rh and K antigens. The frequency of antibody investigations varied widely, and 25% of centers routinely medicated patients before transfusion.</p> </sec> <sec id="trf12571-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Eight thalassemia centers in the United States were surveyed to determine the uniformity of transfusion practice. The variability of the results was surprising. Consequently, we performed a literature review and propose an evidence‐based protocol for routine transfusion therapy for patients with thalassemia.</p> </sec> </abstract>