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Effect of donor type on volume of blood transfusions required after allogeneic hematopoietic cell transplantation

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Abstract

We reviewed blood product use in 729 consecutive allogeneic hematopoietic cell transplantation (allo-HCT) recipients at our center to assess the volume of red blood cells (RBCs) and platelets required after allo-HCT. The median number of bags required by day 30 was 4 for RBCs (range 0–22) and 9.5 for platelets (0–53). Multivariate analysis showed that related peripheral blood stem cell transplantation (PBSCT) required a significantly lower RBC transfusion volume by day 30 compared to unrelated bone marrow transplantation (UBMT). PBSCT from haplo-identical related donors and cord blood transplantation (CBT) required a significantly greater RBC transfusion volume. For platelet transfusion, related and unrelated PBSCT required a significantly lower volume than UBMT, and CBT a greater volume. Other factors independently associated with greater RBC transfusion volume were male sex, disease status other than complete remission, and major ABO mismatch. For platelet transfusion, these were male sex, disease status, and HCT-specific comorbidity index of 1. Although the burden of blood transfusions may not be the most important factor when choosing a donor type, our findings may provide a foundation for nationwide strategies to prepare blood products and inform aspects of national healthcare expenditures.

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References

  1. Gooley TA, Chien JW, Pergam SA, Hingorani S, Sorror ML, Boeckh M, et al. Reduced mortality after allogeneic hematopoietic-cell transplantation. N Engl J Med. 2010;363(22):2091–101.

    Article  CAS  Google Scholar 

  2. Horan JT, Logan BR, Agovi-Johnson MA, Lazarus HM, Bacigalupo AA, Ballen KK, et al. Reducing the risk for transplantation-related mortality after allogeneic hematopoietic cell transplantation: how much progress has been made? J Clin Oncol. 2011;29(7):805–13.

    Article  Google Scholar 

  3. Kurosawa S, Yakushijin K, Yamaguchi T, Atsuta Y, Nagamura-Inoue T, Akiyama H, et al. Changes in incidence and causes of non-relapse mortality after allogeneic hematopoietic cell transplantation in patients with acute leukemia/myelodysplastic syndrome: an analysis of the Japan Transplant Outcome Registry. Bone Marrow Transplant. 2013;48(4):529–36.

    Article  CAS  Google Scholar 

  4. Tanaka Y, Kurosawa S, Tajima K, Tanaka T, Ito R, Inoue Y, et al. Analysis of non-relapse mortality and causes of death over 15 years following allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant. 2016;51(4):553–9.

    Article  CAS  Google Scholar 

  5. Transplantation TJDCfHC (2018) Activities and outcomes of hematopoietic cell transplantation in Japan. http://wwwjdchctorjp/en/data/slide/2018/.

  6. Bensinger WI, Martin PJ, Storer B, Clift R, Forman SJ, Negrin R, et al. Transplantation of bone marrow as compared with peripheral-blood cells from HLA-identical relatives in patients with hematologic cancers. N Engl J Med. 2001;344(3):175–81.

    Article  CAS  Google Scholar 

  7. Blaise D, Kuentz M, Fortanier C, Bourhis JH, Milpied N, Sutton L, et al. Randomized trial of bone marrow versus lenograstim-primed blood cell allogeneic transplantation in patients with early-stage leukemia: a report from the Societe Francaise de Greffe de Moelle. J Clin Oncol. 2000;18(3):537–46.

    Article  CAS  Google Scholar 

  8. Dey BR, Shaffer J, Yee AJ, McAfee S, Caron M, Power K, et al. Comparison of outcomes after transplantation of peripheral blood stem cells versus bone marrow following an identical nonmyeloablative conditioning regimen. Bone Marrow Transplant. 2007;40(1):19–27.

    Article  CAS  Google Scholar 

  9. Solh M, Brunstein C, Morgan S, Weisdorf D. Platelet and red blood cell utilization and transfusion independence in umbilical cord blood and allogeneic peripheral blood hematopoietic cell transplants. Biol Blood Marrow Transplant. 2011;17(5):710–6.

    Article  Google Scholar 

  10. Wang Z, Sorror ML, Leisenring W, Schoch G, Maloney DG, Sandmaier BM, et al. The impact of donor type and ABO incompatibility on transfusion requirements after nonmyeloablative haematopoietic cell transplantation. Br J Haematol. 2010;149(1):101–10.

    Article  CAS  Google Scholar 

  11. Atsuta Y, Suzuki R, Yoshimi A, Gondo H, Tanaka J, Hiraoka A, et al. Unification of hematopoietic stem cell transplantation registries in Japan and establishment of the TRUMP System. Int J Hematol. 2007;86(3):269–74.

    Article  Google Scholar 

  12. Fukuda T, editor (2018) National Cancer Center Hospital Pocket Manual of Stem Cell Traplantation. Tokyo 2018.

  13. Health LaWM. Guidelines for Usage of Blood Products (revised version). 2017.

  14. Bacigalupo A, Ballen K, Rizzo D, Giralt S, Lazarus H, Ho V, et al. Defining the intensity of conditioning regimens: working definitions. Biol Blood Marrow Transplant. 2009;15(12):1628–33.

    Article  Google Scholar 

  15. Giralt S, Ballen K, Rizzo D, Bacigalupo A, Horowitz M, Pasquini M, et al. Reduced-intensity conditioning regimen workshop: defining the dose spectrum. Report of a workshop convened by the center for international blood and marrow transplant research. Biol Blood Marrow Transplant. 2009;15(3):367–9.

    Article  Google Scholar 

  16. Luznik L, O’Donnell PV, Fuchs EJ. Post-transplantation cyclophosphamide for tolerance induction in HLA-haploidentical bone marrow transplantation. Semin Oncol. 2012;39(6):683–93.

    Article  CAS  Google Scholar 

  17. Sugita J, Kagaya Y, Miyamoto T, Shibasaki Y, Nagafuji K, Ota S, et al. Myeloablative and reduced-intensity conditioning in HLA-haploidentical peripheral blood stem cell transplantation using post-transplant cyclophosphamide. Bone Marrow Transplant. 2019;54(3):432–41.

    Article  CAS  Google Scholar 

  18. Sorror ML, Giralt S, Sandmaier BM, De Lima M, Shahjahan M, Maloney DG, et al. Hematopoietic cell transplantation specific comorbidity index as an outcome predictor for patients with acute myeloid leukemia in first remission: combined FHCRC and MDACC experiences. Blood. 2007;110(13):4606–13.

    Article  CAS  Google Scholar 

  19. Kanda Y. Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transplant. 2013;48(3):452–8.

    Article  CAS  Google Scholar 

  20. Heldal D, Tjonnfjord G, Brinch L, Albrechtsen D, Egeland T, Steen R, et al. A randomised study of allogeneic transplantation with stem cells from blood or bone marrow. Bone Marrow Transplant. 2000;25(11):1129–36.

    Article  CAS  Google Scholar 

  21. Majhail NS, Mothukuri JM, Brunstein CG, Weisdorf DJ. Costs of hematopoietic cell transplantation: comparison of umbilical cord blood and matched related donor transplantation and the impact of posttransplant complications. Biol Blood Marrow Transplant. 2009;15(5):564–73.

    Article  Google Scholar 

  22. Matsuno N, Wake A, Uchida N, Ishiwata K, Araoka H, Takagi S, et al. Impact of HLA disparity in the graft-versus-host direction on engraftment in adult patients receiving reduced-intensity cord blood transplantation. Blood. 2009;114(8):1689–95.

    Article  CAS  Google Scholar 

  23. Inamoto Y, Kimura F, Kanda J, Sugita J, Ikegame K, Nakasone H, et al. Comparison of graft-versus-host disease-free, relapse-free survival according to a variety of graft sources: antithymocyte globulin and single cord blood provide favorable outcomes in some subgroups. Haematologica. 2016;101(12):1592–602.

    Article  CAS  Google Scholar 

  24. Kurosawa S, Oshima K, Yamaguchi T, Yanagisawa A, Fukuda T, Kanamori H, et al (2017) Quality of life after allogeneic hematopoietic cell transplantation according to affected organ and severity of chronic graft-versus-host disease. Biol Blood Marrow Transplant

  25. Polizzotto MN, Wood EM, Ingham H, Keller AJ. Reducing the risk of transfusion-transmissible viral infection through blood donor selection: the Australian experience 2000 through 2006. Transfusion. 2008;48(1):55–63.

    PubMed  Google Scholar 

  26. Takamatsu J. Transfusion-transmitted viral infection. Japanese J Clin Hematol. 2007;48(10):1422–7.

    Google Scholar 

  27. Okazaki H. Transfusion-related acute lung injury (TRALI) and transfusion-associated circulatory overload (TACO). Japanese J Clin Pathol. 2013;61(5):399–406.

    CAS  Google Scholar 

  28. Popovsky MA. Pulmonary consequences of transfusion: TRALI and TACO. Transfusion Apheresis Sci. 2006;34(3):243–4.

    Article  Google Scholar 

  29. Solh M, Morgan S, McCullough J, Shanley R, Weisdorf DJ. Blood transfusions and pulmonary complications after hematopoietic cell transplantation. Transfusion. 2016;56(3):653–61.

    Article  Google Scholar 

  30. Hosoba S, Waller EK, Shenvi N, Graiser M, Easley KA, Al-Kadhimi Z, et al. Peritransplantation red blood cell transfusion is associated with increased risk of graft-versus-host disease after allogeneic hematopoietic stem cell transplantation. Biol Blood Marrow Transplant. 2018;24(5):973–82.

    Article  Google Scholar 

Download references

Acknowledgements

This work was supported by a grant from the National Cancer Research and Development Fund (29-A-14).

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Authors and Affiliations

  1. Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan

    Saiko Kurosawa, Yukiko Nishioka, Wataru Takeda, Tuneaki Hirakawa, Jun Aoki, Ayumu Ito, Takashi Tanaka, Yoshihiro Inamoto, Sung-Won Kim, Minoru Kojima & Takahiro Fukuda

  2. Department of Oncology, Ina Central Hospital, 1313-1 Koshiro-kubo, Ina, Nagano, 396-8555, Japan

    Saiko Kurosawa

  3. Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan

    Takuhiro Yamaguchi

  4. Department of Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan

    Saori Nakabayashi, Moemi Kasane, Misato Tsubokura, Nao Iwashita, Yuki Minakawa, Ryuzaburo Ohtake & Kimihiko Kawamura

  5. Japanese Red Cross Society Blood Service Headquarters, Tokyo, Japan

    Minoko Takanashi

Authors
  1. Saiko Kurosawa
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  2. Takuhiro Yamaguchi
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  3. Saori Nakabayashi
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  4. Moemi Kasane
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  5. Misato Tsubokura
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  6. Nao Iwashita
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  9. Kimihiko Kawamura
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  12. Tuneaki Hirakawa
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  13. Jun Aoki
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Contributions

S.K. designed the study, prepared data file, performed data analysis, and wrote the manuscript. T.Y. was primarily responsible for data analysis and interpretation of the data. S.N., M.K., M.T., N.I., Y.M., and R.O. were involved in blood transfusion management, prepared the blood transfusion data file, and interpreted data. K.K. was primarily responsible for services at the Department of Clinical Laboratories, and interpreted data. Y.N. collected clinical data, prepared the national transplant registry database, and interpreted data. W.T., T.H., J.A., A.I., T.T., Y.I., S.W.K., and M.K. provided medical care to allo-HCT patients, and interpreted data. Y.I. additionally helped manipulate the data file. M.T. helped design the study, and interpreted data. T.F. interpreted data and provided administrative support for the study.

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Correspondence to Saiko Kurosawa.

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Kurosawa, S., Yamaguchi, T., Nakabayashi, S. et al. Effect of donor type on volume of blood transfusions required after allogeneic hematopoietic cell transplantation. Int J Hematol 113, 518–529 (2021). https://doi.org/10.1007/s12185-020-03041-2

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  • DOI: https://doi.org/10.1007/s12185-020-03041-2

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