A survey of transfusion practices in pediatric hematopoietic stem cell transplant patients

Rachel S. Bercovitz*, Ralph R. Quinones

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

18 Scopus citations

Abstract

Until recovery of hematopoiesis, pediatric hematopoietic stem cell transplant (HSCT) patients are dependent on red blood cell and platelet transfusions to avoid the complications associated with anemia and thrombocytopenia, respectively. Despite the fact that these patients are high utilizers of blood components, there are no evidence-based guidelines regarding optimal transfusion practices in this patient population. A web-based survey was designed to examine current transfusion thresholds used by institutions that perform pediatric HSCT. This survey was sent to department directors identified through the Children's Oncology Group directory with a response rate of 69%. The majority of institutions use 8 g/dL as the hemoglobin threshold for red blood cell transfusions (60%), but a significant minority use 7 g/dL (25%). With respect to platelet transfusion thresholds, 47% of respondents report using 20×10/L and 44% use 10×10/L. Respondents were also asked about specific clinical scenarios that would prompt an increase in a patient's threshold. This survey revealed that there is variation in transfusion practices among pediatric HSCT institutions with respect to both baseline transfusion threshold and what prompts an increase in threshold. Future clinical trials are needed to determine optimal transfusion thresholds in pediatric HSCT patients, which can lead to improved standardization in practices.

Original languageEnglish (US)
Pages (from-to)e60-e63
JournalJournal of pediatric hematology/oncology
Volume35
Issue number2
DOIs
StatePublished - Mar 1 2013

Keywords

  • hematopoietic stem cell transplant
  • pediatrics
  • platelet transfusion
  • red blood cell transfusion
  • transfusion threshold

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

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