Title | Red Blood Cell Transfusions for Thalassemia: Results of a Survey Assessing Current Practice and Proposal of Evidence-Based Guidelines |
Publication Type | Journal Article |
Year of Publication | 2014 |
Authors | Goss C, Giardina P, Degtyaryova D, Kleinert D, Sheth S, Cushing M |
Journal | Transfusion |
Volume | 54 |
Issue | 7 |
Pagination | 1773-81 |
Date Published | 2014 Jul |
ISSN | 1537-2995 |
Keywords | Blood Preservation, Blood Safety, Data Collection, Erythrocyte Transfusion, Evidence-Based Practice, Humans, Practice Guidelines as Topic, Professional Practice, Surveys and Questionnaires, Thalassemia, United States |
Abstract | BACKGROUND: 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. STUDY DESIGN AND METHODS: 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. RESULTS: 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. CONCLUSION: 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. |
DOI | 10.1111/trf.12571 |
Alternate Journal | Transfusion |
PubMed ID | 24611697 |