Single versus double-unit transfusion: Safety and efficacy for patients with hematologic malignancies

Zelia Bowman; Naomi Fei; Janice Ahn; Sijin Wen; Aaron Cumpston; Nilay Shah; Michael Craig; Peter L Perrotta; Abraham S Kanate

doi:10.1111/ejh.13211

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Single versus double-unit transfusion: Safety and efficacy for patients with hematologic malignancies

Journal article

Open access

Peer reviewed

Single versus double-unit transfusion: Safety and efficacy for patients with hematologic malignancies

Zelia Bowman, Naomi Fei, Janice Ahn, Sijin Wen, Aaron Cumpston, Nilay Shah, Michael Craig, Peter L Perrotta and Abraham S Kanate

European journal of haematology, Vol.102(5), pp.383-388

05/2019

DOI: 10.1111/ejh.13211

PMCID: PMC6542263

PMID: 30664281

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https://www.ncbi.nlm.nih.gov/pmc/articles/6542263View

Open Access

Abstract

Although hemoglobin thresholds for red blood cell (RBC) transfusion have decreased, double-unit RBC transfusion practices persist. We studied the effects switching from predominantly double-unit to single-unit RBC transfusions had on utilization and clinical outcomes for malignant hematology patients. Retrospective chart review compared malignant hematology patients before and after implementing single-unit RBC transfusion policy. Hemoglobin threshold was 8.0 g/dL for both groups. RBC utilization metrics included number of RBC units transfused, RBC units transfused per admission, and number of transfusion episodes. Clinical outcomes included length of stay, 30-day mortality, and outpatient RBC transfusion 30-days post-discharge. Baseline hemoglobin was similar in both groups. The single-unit group was transfused with fewer RBC units per admission (5.1 vs 4.5, P = 0.01) than the double-unit group, but had more transfusion episodes per admission (4.1 vs 2.7, P < 0.001). After implementing single-unit policy, a 29% reduction in RBC utilization was observed. Mean hemoglobin at discharge was lower in the single-unit group (8.9 vs 9.5 g/dL, P = 0.005). No significant differences in length of stay or 30-day mortality were observed. Transfusing malignant hematology patients with single RBC units is safe and efficacious. Electronic provider order systems facilitating RBC transfusion requests provide excellent adherence to transfusion policy.

Adult

Aged

Blood Transfusion - methods

Combined Modality Therapy

Disease Management

Erythrocyte Indices

Erythrocyte Transfusion - adverse effects

Erythrocyte Transfusion - methods

Female

Hematologic Neoplasms - blood

Hematologic Neoplasms - diagnosis

Hematologic Neoplasms - therapy

Humans

Male

Middle Aged

Transfusion Reaction

Treatment Outcome

Details

Title: Subtitle: Single versus double-unit transfusion: Safety and efficacy for patients with hematologic malignancies
Creators: Zelia Bowman - West Virginia University
Naomi Fei - West Virginia University
Janice Ahn - West Virginia University
Sijin Wen - West Virginia University
Aaron Cumpston - West Virginia University
Nilay Shah - West Virginia University
Michael Craig - West Virginia University
Peter L Perrotta - West Virginia University
Abraham S Kanate - West Virginia University
Resource Type: Journal article
Publication Details: European journal of haematology, Vol.102(5), pp.383-388
DOI: 10.1111/ejh.13211
PMID: 30664281
PMCID: PMC6542263
NLM abbreviation: Eur J Haematol
ISSN: 0902-4441
eISSN: 1600-0609
Grant note: U54 GM104942 / NIGMS NIH HHS
Language: English
Date published: 05/2019
Academic Unit: Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
Record Identifier: 9984359840102771

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