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Vol. 14, Art. 90 (pp. 1146-1166)    |    2013       

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Correction of anemia in patients with hematological malignancies using red blood cell transfusions

Romanenko N.A., Bessmeltsev S.S., Belchenko N.A., Gritsaev S.V., Shilova E.R., Glazanova T.V., Potikhonova N.A., Abdulkadyrov K.M.

Russian Research Institute of Hematology and Transfusiology, Russian Federal of Medical-biological Agency, Saint-Petersburg, 191024, 2nd Sovietskaya str., 16

Brief summary

Presented are the efficacy analysis results of anemia correction using red blood cell (RBC) transfusions in patients with hematologic malignancies (n=190). The studied group included patients with MDS (n=39), acute myeloid leukemia (n=28), primary myelofibrosis (n=21), blast crisis of chronic myeloid leukemia (n=10), multiple myeloma (n=42), non-Hodgkin\'s lymphoma (n=19), chronic lymphocytic leukemia (n=22), acute lymphoblastic leukemia (n=6), and acute plasma cell leukemia (n=3). All patients had mild (n=49; 25,8%), moderate (n=61; 32,1%), or severe (n=80; 42,1%) anemia. According to increase of hemoglobin level per one transfusion the patients have been divided into 3 groups. First group (n=57; 30,0%) – with good response to RBC transfusions: hemoglobin increase per one RBC transfusion was ≥10 g/L (11,4±4,4 g/L); in this group hemoglobin increased from 70,4±12,5 g/L to 103,4±6,7 g/L, 2,9±1,5 RBC units transfused in total, 3-month non-related to transfusions mortality was 5,3%. Second group (n=71; 37,4%) – with partial response: Hb increment per each RBC unit – from 5 to 9 g/L (6,6±1,2 g/L); Hb level increased from 68,7±12,2 g/L to 97,6±10,2 g/L, in total transfused 4,5±2,1 RBC units, 3-month non-related to transfusions mortality was 16,9%. Third group (n=62; 32,6%) – with minimal response: Hb increment per each RBC unit – from 1 to 4 g/L (2,6±1,6 g/L); Hb level increased from 72,5±12,4 g/L to 89,2±14,5 г/л, in total transfused 6,4±5,9 RBC units, 3-month mortality was 33,9%, being significantly higher as compared to the 1st and 2nd groups. The main reasons for low efficacy of RBC transfusions were red blood cell hemolysis and significant depression of erythropoiesis, related to disease progression and toxic effect of chemotherapy. Division of patients into subgroups depending on RBC transfusion efficacy allows prediction of the course of underlying disease and more differential approach to treatment of anemic syndrome in patients with hematologic malignancies.


Key words

anemia, red blood cell, red blood cell transfusions, hemoglobin level, hematologic malignancies

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