scholarly journals Transfusion practices for pediatric oncology and hematopoietic stem cell transplantation patients: Data from the National Heart Lung and Blood Institute Recipient Epidemiology and Donor Evaluation Study‐III (REDS‐III)

Transfusion ◽  
2021 ◽  
Author(s):  
Ruchika Goel ◽  
Marianne E. Nellis ◽  
Oliver Karam ◽  
Sheila J. Hanson ◽  
Christopher A. Tormey ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Pediatric Oncology ◽  
Evaluation Study ◽  
Hematopoietic Stem ◽  
Blood Institute ◽  
Donor Evaluation ◽  
National Heart Lung

scholarly journals Transfusion Practices for Pediatric Oncology and Hematopoietic Stem Cell Transplantation Patients: Data from the National Heart Lung and Blood Institute Recipient Epidemiology and Donor Evaluation Study-III (REDS-III)

2021 ◽  
Author(s):  
Ruchika Goel ◽  
Marianne Nellis ◽  
Oliver Karam ◽  
Sheila Hanson ◽  
Christopher Tormey ◽  
...  
Keyword(s):  
Stem Cell ◽  
Platelet Count ◽  
Hematopoietic Stem Cell ◽  
Pediatric Oncology ◽  
Evaluation Study ◽  
Hematopoietic Stem ◽  
Blood Institute ◽  
National Heart ◽  
Donor Evaluation ◽  
National Heart Lung

Purpose: To evaluate transfusion practices in pediatric oncology and hematopoietic stem cell transplant (HSCT) patients. Methods: This is a multicenter retrospective study of children with oncologic diagnoses treated from 2013-2016 at hospitals that participated in the National Heart Lung and Blood Institute Recipient Epidemiology and Donor Evaluation Study-III (REDS-III). Transfusion practices were evaluated by diagnosis code and pre-transfusion laboratory values. Results: A total of 4766 inpatient encounters of oncology and HSCT patients were evaluated, with 39.3% (95% CI 37.9-40.7%) involving a transfusion. Red blood cells (RBCs) were the most commonly transfused component (32.4%; 95% CI 31.1-33.8%), followed by platelets (22.7%; 95% CI 21.5-23.9%). Patients in the 1 to <6-year old age range were most likely to be transfused and HSCT, acute myelogenous leukemia, and aplastic anemia were the diagnoses most often associated with transfusion. The median hemoglobin (Hb) prior to RBC transfusion was 7.5 g/dL (10-90th percentile: 6.4-8.8 g/dL), with 45.7% of transfusions being given at 7-<8 g/dL. The median platelet count prior to platelet transfusion was 20x109/L (10-90th percentile: 8-51x109/L), and 37.9% of transfusions were given at platelet count of >20-50x109/L. The median international normalized ratio (INR) prior to plasma transfusion was 1.7 (10-90th percentile: 1.3-2.7), and 36.3% of plasma transfusions were given at an INR between >1.4-1.7. Conclusion: Transfusion of blood components is common in hospitalized children with cancer. Relatively high pre-transfusion Hb and platelet values and relatively low INR values prior to transfusion across the studied diagnoses highlight the need for evidence- based practice in this population.

scholarly journals Thrombocytopenia and bleeding in pediatric oncology patients

Hematology ◽  
2012 ◽  
Vol 2012 (1) ◽  
pp. 499-505 ◽  
Author(s):  
Rachel S. Bercovitz ◽  
Cassandra D. Josephson
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Pediatric Oncology ◽  
Recurrent Bleeding ◽  
Transfusion Threshold ◽  
Hematopoietic Stem ◽  
Platelet Transfusions

Abstract Prophylactic platelet transfusions are the standard of care for patients with hypoproliferative thrombocytopenia after receiving chemotherapy or radiation for the treatment of malignancy, for BM replacement by leukemia or solid tumor, or in preparation for a hematopoietic stem cell transplantation.1 During this time of thrombocytopenia, these patients may receive both prophylactic platelet transfusions, which are given to prevent potentially life-threatening bleeding when a patient's platelet count drops below a predetermined threshold, and therapeutic platelet transfusions, which are given to treat active or recurrent bleeding. In the 1950s, the invention of the plastic blood bag allowed for the production and storage of platelet concentrates,2 and in the 1960s, it was recognized that prophylactic platelet transfusions effectively reduced hemorrhagic death in patients with newly diagnosed leukemia.3,4 In 1962, Gaydos published the paper that is frequently credited with the inception of the 20 000/μL platelet transfusion threshold.5 Despite a half-century of experience with prophylactic platelet transfusions, there are still insufficient data to provide clinicians with evidence-based guidelines specific to pediatric oncology and hematopoietic stem cell transplantation (HSCT) patients.

scholarly journals 2857. A Statistical Model to Predict Invasive Fungal Disease in Pediatric Cancer and Hematopoietic Stem Cell Transplantation Patients

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S76-S76
Author(s):  
Muayad Alali ◽  
Madan Kumar
Keyword(s):  
Risk Factors ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Pediatric Oncology ◽  
Pediatric Cancer ◽  
Oncology Patients ◽  
Hematopoietic Stem

Abstract Background Invasive fungal diseases (IFDs) are devastating opportunistic infections that result in significant morbidity and death in pediatric cancer and hematopoietic stem cell transplantation (SCT) patients. Identification of risk factors for IFD will help clinical decisions relevant to the diagnosis and management of IFD in a timely manner. Despite this, data evaluating prediction risk tools for IFD in pediatric cancer are limited. Methods We conducted a retrospective review of pediatric oncology patients with a diagnosis of febrile neutropenia (FN) at UChicago Comer Children’s Hospital from July 2009 to December 2016. We analyzed 13 clinical, laboratory, and treatment-related risk factors for IFD including (age, gender, underlying diagnosis, SCT status, graft vs. host disease, chemotherapy in the last 2 weeks, temperature, height, fever duration, presence of hypotension, absolute neutrophil count, duration of neutropenia, absolute monocyte count, and the absolute lymphocyte count (ALC)). IFD was stratified as possible, probable, and proven according to the latest EORTC/MSG criteria (2008). Multivariable logistic regression risk prediction models were developed with separate analyses for all suspected IFD cases and only proven and probable cases. Results A total of 667 FN episodes (FNEs) were identified in 265 patients. IFD was diagnosed in 62 episodes (9.2%) of which 13 (1.9%) were proven, 27 (4%) probable, and 22 (3.3%) possible. Five variables obtained were significantly more common in IFD. Patients presenting with hypotension and fever >5 days were highly associated with IFD (P < 0.001). SCT receipts (P < 0.01), neutropenia longer than 10 days (P = 0.02), and ALC <300 mm3 at time of presentation (P = 0.03) were additional risk factors. The final model performs very well compared with other published models with a receiver operating characteristic–area under the curve (ROC-AUC) of 86.5 for all IFD cases and ROC-AUC of 84.5 for proven, probable IFD cases. Conclusion Our findings showed important clinical markers for the development of IFD in pediatric oncology patients. A predictive regression model including identified significant factors has been created. Risk stratification with prospective external validation using this model can be used to refine the clinical approach. Disclosures All Authors: No reported Disclosures.

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