Abstract | BACKGROUND: In the absence of curative treatment, such as stem cell transplant, regular transfusions remain the mainstay of therapy for individuals with thalassemia major, a syndrome that results from marked ineffective erythropoiesis and the resultant anemia. The primary objectives of transfusion therapy are twofold: to suppress ineffective erythropoiesis and to ensure appropriate growth and development through childhood. In practice, a number of different transfusion protocols are in use across the developed world, with on-demand transfusion still being the paradigm in most of the developing world with limited resources. STUDY DESIGN AND METHODS: To investigate perceived differences in transfusion practice, a self-reported electronic survey was disseminated to eight US thalassemia treatment centers in February 2011. The survey was divided into sections ranging from laboratory and clinical practices to emerging transfusion-transmitted diseases. RESULTS: The survey response rate was 100%. The total number of transfused patients was 411. One-hundred percent of institutions used leukoreduced blood. No centers routinely provided cytomegalovirus-seronegative red blood cells (RBCs). Half the centers provided irradiated RBCs; only one routinely provided washed RBCs, and none transfused RBCs of defined storage age. Seventy-five percent of centers routinely phenotyped thalassemia patients' RBC antigens; 50% prophylactically matched for Rh and K antigens. The frequency of antibody investigations varied widely, and 25% of centers routinely medicated patients before transfusion. CONCLUSION: Eight thalassemia centers in the United States were surveyed to determine the uniformity of transfusion practice. The variability of the results was surprising. Consequently, we performed a literature review and propose an evidence-based protocol for routine transfusion therapy for patients with thalassemia.
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Authors | Cheryl Goss, Patricia Giardina, Diana Degtyaryova, Dorothy Kleinert, Sujit Sheth, Melissa Cushing |
Journal | Transfusion
(Transfusion)
Vol. 54
Issue 7
Pg. 1773-81
(Jul 2014)
ISSN: 1537-2995 [Electronic] United States |
PMID | 24611697
(Publication Type: Journal Article, Review)
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Copyright | © 2014 AABB. |
Topics |
- Blood Preservation
(methods, standards)
- Blood Safety
(methods, standards)
- Data Collection
- Erythrocyte Transfusion
(methods, standards, statistics & numerical data)
- Evidence-Based Practice
(standards)
- Humans
- Practice Guidelines as Topic
- Professional Practice
(standards, statistics & numerical data)
- Surveys and Questionnaires
- Thalassemia
(epidemiology, therapy)
- United States
(epidemiology)
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