Asian Journal of Transfusion Science
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Influence of blood transfusion during induction chemotherapy on treatment outcomes in acute myeloid leukemia


1 Department of Clinical Hematology and Medical Oncology, Malabar Cancer Centre, Thalassery, Kerala, India
2 Department of Transfusion Medicine, Malabar Cancer Centre, Thalassery, Kerala, India
3 Department of Oncopathology, Malabar Cancer Centre, Thalassery, Kerala, India

Correspondence Address:
Mohandoss Murugesan,
Department of Transfusion Medicine, Malabar Cancer Centre, Thalassery, Kerala
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ajts.ajts_123_21

BACKGROUND: Transfusion is an integral part of supportive care in patients undergoing aggressive chemotherapy for acute myeloid leukemia (AML). As transfusion induces immune modulation, the objective of the study was to assess whether the intensity of red blood cell (RBC) and platelet (PLT) transfusion during induction chemotherapy influences complete remission (CR) and overall survival (OS) in newly diagnosed AML patients. METHODS: Details of the number of RBC units and PLT events transfused from diagnosis till completion of induction chemotherapy were collected. Patients were stratified as high or low intensity for transfusion based on median RBC units and PLT events transfused per week. The influence of transfusion intensity on CR and OS was estimated using multivariate analysis and log-rank test, respectively. RESULTS: Among 90 patients analyzed, the median RBC unit required was 1.7 units/week and PLT transfused was 1.5 events/week. Patients requiring transfusion at disease presentation had significantly higher intensity of RBC and PLT transfusions. Only high intensity for RBC transfusion (P = 0.016) appeared among prognostic factors for achieving CR. The OS was not affected in patients requiring high intensity of RBC (P = 0.314) and PLT (P = 0.504) transfusions. CONCLUSION: Transfusion support was higher in patients with a high disease burden at diagnosis. The lower intensity of RBC transfusion goes along with the response to chemotherapy in terms of CR but not OS.


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2006 - Asian Journal of Transfusion Science | Published by Wolters Kluwer - Medknow
Online since 10th November, 2006