| Prolonged isolated red blood cell transfusion requirement after allogeneic blood stem cell transplantation: identification of patients at risk. | |
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MedLine Citation:
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PMID: 19929861 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Delayed donor red blood cell chimerism (DRCC), pure red blood cell aplasia (PRCA), and autoimmune hemolytic anemia (AIHA) are poorly documented complications after hematopoietic cell transplantation (HCT). The clinical variable "prolonged isolated red blood cell transfusion requirement" (PRTR) was evaluated as a trigger for an extended diagnostic workup. STUDY DESIGN AND METHODS: PRTR was defined as the need for red blood cell (RBC) transfusions beyond Day 60 after HCT. We analyzed 487 patients transplanted between 2000 and 2006. Median age was 37 years (range, 0-70 years). Peripheral blood stem cells (n = 344), marrow (n = 138), and cord blood (n = 5) from 278 unrelated and 209 family donors were used. RESULTS: Univariate analysis identified age (incidence of 18.3% among elderly patients, 10.5% in adults, and 2.0% among children [p = 0.002]), ABO incompatibility (16.4% after major incompatible, 2.9% after minor incompatible, and 9.4% after ABO-compatible transplantations [p = 0.003]), conditioning (15.2% after reduced-intensity regimens vs. 7.3% after myeloablative conditioning; p = 0.006), donor type (13.2% after HLA-matched unrelated, 13.6% after mismatched unrelated, 5.7% after matched related, and 0.0% after mismatched related grafts; p = 0.026), and acute graft-versus-host disease (aGVHD; 7.1% with aGVHD vs. 12.5% without aGVHD; p = 0.046) as predisposing factors. In multivariate analysis minor ABO incompatibility (odds ratio [OR] = 0.2, p = 0.01), younger age (OR = 0.1, p = 0.02), and matched related HCT (OR = 0.4, p = 0.02) remained independent protective factors. CONCLUSIONS: PRTR could serve as a trigger for a standardized screening for DRCC, PRCA, and AIHA after HCT. |
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Authors:
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Daphne Dahl; Andreas Hahn; Christian Koenecke; Hans-Gert Heuft; Elke Dammann; Michael Stadler; Stefanie Buchholz; Jürgen Krauter; Matthias Eder; Karl-Walter Sykora; Christoph Klein; Arnold Ganser; Martin Sauer |
Publication Detail:
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Type: Journal Article Date: 2009-11-19 |
Journal Detail:
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Title: Transfusion Volume: 50 ISSN: 1537-2995 ISO Abbreviation: Transfusion Publication Date: 2010 Mar |
Date Detail:
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Created Date: 2010-07-08 Completed Date: 2010-07-27 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0417360 Medline TA: Transfusion Country: United States |
Other Details:
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Languages: eng Pagination: 649-55 Citation Subset: IM |
Affiliation:
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Departments of Pediatric Hematology/Oncology, Medizinische Hochschule Hannover, Hannover, Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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ABO Blood-Group System Acute Disease Adolescent Adult Age Factors Aged Anemia, Hemolytic, Autoimmune / etiology, therapy* Blood Group Incompatibility / therapy Child Child, Preschool Cord Blood Stem Cell Transplantation* Erythrocyte Transfusion* Female Graft vs Host Disease / etiology, therapy* Humans Infant Infant, Newborn Male Middle Aged Peripheral Blood Stem Cell Transplantation* Red-Cell Aplasia, Pure / etiology, therapy* Retrospective Studies Risk Factors Transplantation Chimera Transplantation Conditioning* Transplantation, Homologous |
| Chemical | |
Reg. No./Substance:
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0/ABO Blood-Group System |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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