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Arquivos de Medicina

On-line version ISSN 2183-2447

Abstract

AMADO, Fátima et al. Transfusion Requirements After Allogeneic Hematopoietic Stem Cell Transplantation . Arq Med [online]. 2007, vol.21, n.3-4, pp.91-96. ISSN 2183-2447.

We retrospectively studied all the first allogeneic hematopoietic stem cell transplantation (HSCT) performed in our Centre between January 2003 and September 2005. We evaluated the influence of haematopoietic stem cell source, ABO and HLA compatibility and relationship in donor/recipient pair as well as conditioning regimen (myeloablative versus reduced intensity) on transfusion requirements. We analysed patients’ transfusion requirements during a 100 days period after transplantation. The medians of red blood cells (RBC) and platelets (PL) transfusion episodes (TE) were considered as an estimative of the transfusion requirements. We performed a statistical analysis recurring to the SPSS® software. Ninety four patients (43.6% women, 56.4% men), median age 38.5 years (range 6 months-66 years), were submitted to a first HSCT. In 88.3% (n=83) of patients the haematopoietic stem cell source was peripheral blood, in 7.4% (n=7) bone marrow (BM) and in 4.3% (n=4) umbilical cord blood (UCB). In 95.7% of cases there was HLA compatibility and in 87.2% a relationship between the donor and the recipient. We observed a major ABO incompatibility in 27.6% (n=26) of cases and minor in 10.6% (n=10). In 57.4% (n=54) of transplants there was ABO compatibility. Conditioning regimen was myeloablative and of reduced intensity in 53.2% (n=50) and in 46.8% (n=44) of patients, respectively. We observed that ABO compatibility had not a major impact on transfusion requirements (p>0.05). Patients transplanted with peripheral blood progenitor cells (PBPC) showed a tendency to a lesser PL transfusion need when compared to patients transplanted with UCB and BM but the test applied was not significant for RBC, probably because of the low number UCB and BM transplants considered in this study. Reduced intensity conditioning was associated with a reduced PL transfusion need (p< 0.0001). In unrelated transplants and HLA mismatches the transfusion episodes after transplantation were not higher when compared to related and HLA compatible transplants (p>0.05).

Keywords : hematopoietic; stem cell transplantation; transfusion.

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