Red blood cell utilization and transfusion triggers in patients diagnosed with chronic lymphocytic leukaemia in Iceland 2003-2016.
To access publisher's full text version of this article click on the hyperlink below BACKGROUND AND OBJECTIVES: Revised Icelandic guidelines proposed a restrictive haemoglobin (Hb) threshold of 70 g/l for red blood cell (RBC) transfusions in general, but 100 g/l for malignancies/bone marrow sup...
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Online Access: | http://hdl.handle.net/2336/621052 https://doi.org/10.1111/vox.12775 |
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ftlandspitaliuni:oai:www.hirsla.lsh.is:2336/621052 2023-05-15T16:52:20+02:00 Red blood cell utilization and transfusion triggers in patients diagnosed with chronic lymphocytic leukaemia in Iceland 2003-2016. Thorvaldsson, Hrafn Hliddal Vidarsson, Brynjar Sveinsdottir, Signy Vala Olafsson, Gunnar Bjorn Halldorsdottir, Anna Margret 1 Faculty of Medicine, University of Iceland, Reykjavik, Iceland. 2 Department of Hematology, Landspitali National University Hospital of Iceland, Reykjavik, Iceland. 3 Blood Bank, Landspitali National University Hospital of Iceland, Reykjavik, Iceland. 2019-09 http://hdl.handle.net/2336/621052 https://doi.org/10.1111/vox.12775 en eng Wiley https://onlinelibrary.wiley.com/doi/full/10.1111/vox.12775 Red blood cell utilization and transfusion triggers in patients diagnosed with chronic lymphocytic leukaemia in Iceland 2003-2016. 2019, 114(5):495-504 Vox Sang 1423-0410 30972770 doi:10.1111/vox.12775 http://hdl.handle.net/2336/621052 Vox Sanguinis National Consortium - Landsaðgangur Vox sanguinis epidemiology transfusion medicine (in general) transfusion therapy Langvinnt eitilfrumuhvítblæði Hvítblæði Blóðgjöf Leukemia Lymphocytic Chronic B-Cell Erythrocyte Transfusion Article 2019 ftlandspitaliuni https://doi.org/10.1111/vox.12775 2022-05-29T08:22:26Z To access publisher's full text version of this article click on the hyperlink below BACKGROUND AND OBJECTIVES: Revised Icelandic guidelines proposed a restrictive haemoglobin (Hb) threshold of 70 g/l for red blood cell (RBC) transfusions in general, but 100 g/l for malignancies/bone marrow suppression. Chronic lymphocytic leukaemia (CLL) is frequently complicated by anaemia. The objective was to investigate RBC transfusion practices in CLL. MATERIALS AND METHODS: This retrospective nation-wide study utilized an Icelandic registry of CLL patients diagnosed between 2003 and 2016. Medical records were reviewed and haemoglobin transfusion triggers compared for two periods: Earlier (2003-2012) and latter (2013-2017). RESULTS: Two hundred and thirteen patients were diagnosed with CLL over the period whereof 77 (36·2%) received RBC transfusion(s). Median time from diagnosis to first transfusion was 2·2 years. Higher age, Rai stage 3/4 at diagnosis (P < 0·05) and chemotherapy (P < 0·001) were associated with increased odds of transfusions. Shorter time to first transfusion correlated with higher age (P < 0·001) and Rai stage (P = 0·02) at diagnosis. The mean Hb trigger was 90·4 and 81·2 in the earlier and latter period respectively (P = 0·01). This difference in Hb triggers was most pronounced in patients without documented bone marrow involvement, or 80·5 g/l compared to 93·5 g/l (P = 0·004). The median time from diagnosis to transfusion was longer in the latter period (2·9 years vs. 1·6 years, P = 0·01). After RBC transfusions the survival decreased significantly (P < 0·001). CONCLUSION: One-third of CLL patients received RBC transfusions but few were heavily transfused. Older age, Rai stage, and chemotherapy predicted RBC use. The Hb transfusion trigger decreased over time while time to first RBC transfusion increased. RBC transfusions predict poor survival. Harold-Gunson foundation Article in Journal/Newspaper Iceland Hirsla - Landspítali University Hospital research archive Vox Sanguinis 114 5 495 504 |
institution |
Open Polar |
collection |
Hirsla - Landspítali University Hospital research archive |
op_collection_id |
ftlandspitaliuni |
language |
English |
topic |
epidemiology transfusion medicine (in general) transfusion therapy Langvinnt eitilfrumuhvítblæði Hvítblæði Blóðgjöf Leukemia Lymphocytic Chronic B-Cell Erythrocyte Transfusion |
spellingShingle |
epidemiology transfusion medicine (in general) transfusion therapy Langvinnt eitilfrumuhvítblæði Hvítblæði Blóðgjöf Leukemia Lymphocytic Chronic B-Cell Erythrocyte Transfusion Thorvaldsson, Hrafn Hliddal Vidarsson, Brynjar Sveinsdottir, Signy Vala Olafsson, Gunnar Bjorn Halldorsdottir, Anna Margret Red blood cell utilization and transfusion triggers in patients diagnosed with chronic lymphocytic leukaemia in Iceland 2003-2016. |
topic_facet |
epidemiology transfusion medicine (in general) transfusion therapy Langvinnt eitilfrumuhvítblæði Hvítblæði Blóðgjöf Leukemia Lymphocytic Chronic B-Cell Erythrocyte Transfusion |
description |
To access publisher's full text version of this article click on the hyperlink below BACKGROUND AND OBJECTIVES: Revised Icelandic guidelines proposed a restrictive haemoglobin (Hb) threshold of 70 g/l for red blood cell (RBC) transfusions in general, but 100 g/l for malignancies/bone marrow suppression. Chronic lymphocytic leukaemia (CLL) is frequently complicated by anaemia. The objective was to investigate RBC transfusion practices in CLL. MATERIALS AND METHODS: This retrospective nation-wide study utilized an Icelandic registry of CLL patients diagnosed between 2003 and 2016. Medical records were reviewed and haemoglobin transfusion triggers compared for two periods: Earlier (2003-2012) and latter (2013-2017). RESULTS: Two hundred and thirteen patients were diagnosed with CLL over the period whereof 77 (36·2%) received RBC transfusion(s). Median time from diagnosis to first transfusion was 2·2 years. Higher age, Rai stage 3/4 at diagnosis (P < 0·05) and chemotherapy (P < 0·001) were associated with increased odds of transfusions. Shorter time to first transfusion correlated with higher age (P < 0·001) and Rai stage (P = 0·02) at diagnosis. The mean Hb trigger was 90·4 and 81·2 in the earlier and latter period respectively (P = 0·01). This difference in Hb triggers was most pronounced in patients without documented bone marrow involvement, or 80·5 g/l compared to 93·5 g/l (P = 0·004). The median time from diagnosis to transfusion was longer in the latter period (2·9 years vs. 1·6 years, P = 0·01). After RBC transfusions the survival decreased significantly (P < 0·001). CONCLUSION: One-third of CLL patients received RBC transfusions but few were heavily transfused. Older age, Rai stage, and chemotherapy predicted RBC use. The Hb transfusion trigger decreased over time while time to first RBC transfusion increased. RBC transfusions predict poor survival. Harold-Gunson foundation |
author2 |
1 Faculty of Medicine, University of Iceland, Reykjavik, Iceland. 2 Department of Hematology, Landspitali National University Hospital of Iceland, Reykjavik, Iceland. 3 Blood Bank, Landspitali National University Hospital of Iceland, Reykjavik, Iceland. |
format |
Article in Journal/Newspaper |
author |
Thorvaldsson, Hrafn Hliddal Vidarsson, Brynjar Sveinsdottir, Signy Vala Olafsson, Gunnar Bjorn Halldorsdottir, Anna Margret |
author_facet |
Thorvaldsson, Hrafn Hliddal Vidarsson, Brynjar Sveinsdottir, Signy Vala Olafsson, Gunnar Bjorn Halldorsdottir, Anna Margret |
author_sort |
Thorvaldsson, Hrafn Hliddal |
title |
Red blood cell utilization and transfusion triggers in patients diagnosed with chronic lymphocytic leukaemia in Iceland 2003-2016. |
title_short |
Red blood cell utilization and transfusion triggers in patients diagnosed with chronic lymphocytic leukaemia in Iceland 2003-2016. |
title_full |
Red blood cell utilization and transfusion triggers in patients diagnosed with chronic lymphocytic leukaemia in Iceland 2003-2016. |
title_fullStr |
Red blood cell utilization and transfusion triggers in patients diagnosed with chronic lymphocytic leukaemia in Iceland 2003-2016. |
title_full_unstemmed |
Red blood cell utilization and transfusion triggers in patients diagnosed with chronic lymphocytic leukaemia in Iceland 2003-2016. |
title_sort |
red blood cell utilization and transfusion triggers in patients diagnosed with chronic lymphocytic leukaemia in iceland 2003-2016. |
publisher |
Wiley |
publishDate |
2019 |
url |
http://hdl.handle.net/2336/621052 https://doi.org/10.1111/vox.12775 |
genre |
Iceland |
genre_facet |
Iceland |
op_source |
Vox sanguinis |
op_relation |
https://onlinelibrary.wiley.com/doi/full/10.1111/vox.12775 Red blood cell utilization and transfusion triggers in patients diagnosed with chronic lymphocytic leukaemia in Iceland 2003-2016. 2019, 114(5):495-504 Vox Sang 1423-0410 30972770 doi:10.1111/vox.12775 http://hdl.handle.net/2336/621052 Vox Sanguinis |
op_rights |
National Consortium - Landsaðgangur |
op_doi |
https://doi.org/10.1111/vox.12775 |
container_title |
Vox Sanguinis |
container_volume |
114 |
container_issue |
5 |
container_start_page |
495 |
op_container_end_page |
504 |
_version_ |
1766042520027922432 |