Impact of Blood Transfusion on Haematopoietic Stem Cell Transplantation Outcome

Introduction: Allogeneic Haematopoietic Stem Cell Transplantation (AHSCT) is a potentially curative therapy for many haematological malignancies. Nearly all patients who undergo AHSCT require frequent transfusion of blood products until Red Blood Cells (RBCs) and platelet engraftment occur. However, blood transfusion has seldom been studied as a risk factor for adverse post-transplant outcome. Aim: To investigate the impact of blood transfusion on post-transplant outcome. Materials and Methods: This single-center retrospective study, analysed the data of 50 adult patients with haematological malignancies who had received AHSCT, regarding the incidence of infection, acute and chronic Graft Versus Host Disease (GVHD) and overall survival, for one year after AHSCT. The collected data was divided into two groups according to the amount of transfused RBCs and platelet units; the low transfusion group (<10 units, n=30) and high transfusion group (>10 units, n=20). Results: The incidence of infectious episodes and GVHD development were significantly higher among the high transfusion group than that in low transfusion group (p=0.006) and (p=0.02), respectively. In the low transfusion group, the incidence of acute GVHD was 3.3% and of the chronic GVHD was 3.3% while in high transfusion group, the incidence of acute GVHD was 15% and of chronic GVHD was 20%. The overall survival was significantly lower in the high transfusion group 25% than that in the low transfusion group, 46.7% (p=0.02) during the first year post-transplant. Conclusion: Data from the present study indicate that higher transfusion history was associated with increased risk of infection, development of GVHD and worse overall survival in patients who received AHSCT. Thus, new rational for improving transfusion practice based on symptoms driven criteria for such patients is highly warranted.