Adverse transfusion reactions in patients with aplastic anaemia or myelodysplastic syndromes

Abstract

Background and Objectives Patients with aplastic anaemia or myelodysplastic syndromes frequently receive transfusions in an attempt to correct anaemia and/ or thrombocytopenia, putting them at risk of adverse transfusion reactions. The aim of this study is to evaluate the incidence and the types of adverse transfusion reactions in these patients. Materials and MethodsAdverse transfusion reaction reported in transfused patients with aplastic anaemia or myelodysplastic syndromes from all the hospitals in the Auvergne-Rhône-Alpes region of France were extracted from the national haemovigilance database system and analysed. The types of adverse transfusion reactions, their incidence, their severity, the blood component involved and its imputability were evaluated.Results From 1 January 2010 to 30 June 2016, 7174 adverse transfusion reactions were reported. Seventy adverse transfusion reactions (0Á9%) were reported in patients with aplastic anaemia and 193 (2Á7%) in patients with myelodysplastic syndromes. Febrile non-haemolytic transfusion reaction was the most common reaction both aplastic anaemia (23 cases, 33Á0%) and myelodysplastic syndrome (56 cases, 29Á0%). Post-transfusion red blood cell alloimmunization was also high in both these groups (17Á1% in patients with aplastic anaemia and 22Á3% in patients with myelodysplastic syndrome) frequently involving anti-JK1 (Jk a ) specificity.Conclusion Febrile non-haemolytic transfusion reaction was the most common adverse transfusion reaction in patients with aplastic anaemia or myelodysplastic syndromes who received transfusions. Post-transfusion red blood cell alloimmunization was also observed frequently, but the use of RH-KEL 1 (Rhesus-Kell)matched red blood cell concentrates reduces this risk.

Somatic mutations show no clear association with red blood cell or human leukocyte antigen alloimmunization in de novo or therapy‐related myelodysplastic syndrome

“…Thus, we may be underpowered to detect weaker associations. Furthermore, not all of our patients had a history of in‐house transfusion, which may explain why our alloimmunization prevalence of 11.1% is less than prior studies, 11%–58.6% 3–13 . This is a limitation of performing a study in a tertiary care center as many patients are diagnosed or managed at outside centers with records unavailable at the tertiary center.…”

“…Furthermore, not all of our patients had a history of in-house transfusion, which may explain why our alloimmunization prevalence of 11.1% is less than prior studies, 11%-58.6%. [3][4][5][6][7][8][9][10][11][12][13] This is a limitation of performing a study in a tertiary care center as many patients are diagnosed or managed at outside centers with records unavailable at the tertiary center. Many patients had reported outside transfusion data, while others had no outside clinical records available, therefore no further assessment was performed.…”

“…RBC alloimmunization occurs in approximately 2%-6% of the generalized hospital population, but reported rates in MDS are significantly higher, ranging from 11% to 58.6%. [3][4][5][6][7][8][9][10][11][12][13] Prior work has shown that increased RBC transfusions are associated with increased alloimmunization and likewise that alloimmunization leads to increased transfusion requirements in this group. 3,8 Research in this area using the South Australian-MDS registry has shown low-grade MDS, as defined by the (IPSS-R), is associated with increased risk of alloimmunization, while disease-modifying therapy is associated with decreased risk.…”

“…RBC alloimmunization occurs in approximately 2%–6% of the generalized hospital population, but reported rates in MDS are significantly higher, ranging from 11% to 58.6% 3–13 . Prior work has shown that increased RBC transfusions are associated with increased alloimmunization and likewise that alloimmunization leads to increased transfusion requirements in this group 3,8 .…”

Aloimunização eritrocitária em pacientes politransfundidos com doenças onco-hematológicas: Uma revisão de literatura

“…De acordo com a literatura, dentre as doenças onco-hematológicas mais prevalentes no grupo de pacientes politransfundidos, destacam-se as Síndromes Mielodisplásicas (SMD) e as leucemias agudas (Evers, et al, 2017;Abo el Fetouh, 2020). As SMD compreendem um grupo de doenças clonais manifestadas por citopenia periférica associada à hiperplasia medular e alto risco de transformação para Leucemia Mieloide Aguda (LMA) (Rozovski, et al, 2015;Leisch, et al, 2017;Moncharmont, et al, 2019). As leucemias, grupo de neoplasias malignas do tecido hematopoiético, sãoclassificadas em agudas e crônicas, e em mieloide ou linfoide (Moraes, et al, 2017).…”