TY  - JOUR
A1  - Ballo, Olivier
A1  - Fleckenstein, Philine
A1  - Eladly, Fagr
A1  - Kreisel, Eva-Maria
A1  - Stratmann, Jan Alexander
A1  - Seifried, Erhard
A1  - Müller, Markus
A1  - Serve, Hubert
A1  - Bug, Gesine
A1  - Bönig, Halvard-Björn
A1  - Brandts, Christian Hubertus
A1  - Finkelmeier, Fabian
T1  - Reducing the red blood cell transfusion threshold from 8·0 g/dl to 7·0 g/dl in acute myeloid leukaemia patients undergoing induction chemotherapy reduces transfusion rates without adversely affecting patient outcome
T2  - Vox Sanguinis
N2  - Background and Objectives: Red blood cell (RBC) transfusions are needed by almost every acute myeloid leukaemia (AML) patient undergoing induction chemotherapy and constitute a cornerstone in supportive measures for cancer patients in general. Randomized controlled trials have shown non‐inferiority or even superiority of restrictive transfusion guidelines over liberal transfusion guidelines in specific clinical situations outside of medical oncology. In this study, we analysed whether more restrictive RBC transfusion reduces blood use without affecting hard outcomes.
Materials and Methods: A total of 352 AML patients diagnosed between 2007 and 2018 and undergoing intensive induction chemotherapy were included in this retrospective analysis. In the less restrictive transfusion group, patients received RBC transfusion for haemoglobin levels below 8 g/dl (2007–2014). In the restrictive transfusion group, patients received RBC transfusion for haemoglobin levels below 7 g/dl (2016–2018). Liberal transfusion triggers were never endorsed.
Results: A total of 268 (76·1%) and 84 (23·9%) AML patients fell into the less restrictive and restrictive transfusion groups, respectively. The less restrictive transfusion group had 1 g/dl higher mean haemoglobin levels, received their first RBC transfusions earlier and needed 1·5 more units of RBC during the hospital stay of induction chemotherapy. Febrile episodes, C‐reactive protein levels, admission to the intensive care unit, length of hospital stay as well as response and survival rates did not differ between the two cohorts.
Conclusion: From our retrospective analysis, we conclude that a more restrictive transfusion trigger does not affect important outcomes of AML patients. The opportunity to test possible effects of the more severe anaemia in the restrictive transfusion group on quality of life was missed.
KW  - acute myeloid leukaemia
KW  - induction chemotherapy
KW  - RBC
KW  - transfusion
Y1  - 2020
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/56436
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-564366
SN  - 1423-0410
SN  - 0042-9007
VL  - 115
IS  - 7
SP  - 570
EP  - 578
PB  - Wiley-Blackwell
CY  - Oxford [u.a.]
ER  -