Red blood cell utilization and transfusion triggers in patients diagnosed with chronic lymphocytic leukaemia in Iceland 2003–2016
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 obj...
Gespeichert in:
| Veröffentlicht in: | Vox sanguinis 2019-07, Vol.114 (5), p.495-504 |
|---|---|
| Hauptverfasser: | , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 504 |
|---|---|
| container_issue | 5 |
| container_start_page | 495 |
| container_title | Vox sanguinis |
| container_volume | 114 |
| creator | Thorvaldsson, Hrafn Hliddal Vidarsson, Brynjar Sveinsdottir, Signy Vala Olafsson, Gunnar Bjorn Halldorsdottir, Anna Margret |
| description | 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 |
| doi_str_mv | 10.1111/vox.12775 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2207936134</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2255999763</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3135-caadc366f958dfcf657263186c1752419e4526eb082e1b7bb7b5be20d70f28ac3</originalsourceid><addsrcrecordid>eNp1kcFKHTEUhoNU9Gq78AUk0I0uRk-SSTKzFNFWEATR0t2QyWTujc4k12RGvV0V-gh9wz5JM151UWgIJAe-fDmHH6E9AkckreNH_3xEqJR8A81ITlkGOYEPaAaQ06wEkNtoJ8Y7AChowbfQNoNSJh5m6Ne1aXDded9gbboOj4Pt7A81WO-wcg0egnKxHeNUD8HO5yZEbB1eJsS4IeLGqrnzMVme7LDAehG8sxp3q3658Ho1THcz3ivTWzU9vEjfTGIKwP78_E2BiI9os1VdNJ9ez110e352c_o1u7z6cnF6cplpRhjPtFKNZkK0JS-aVreCSyoYKYQmktOclCbnVJg6DWlILeu0eW0oNBJaWijNdtHB2rsM_mE0cah6G6eplTN-jBWlIEsmCMsT-vkf9M6PwaXuEsV5WZZSsEQdrikdfIzBtNUy2F6FVUWgmpKpUjLVSzKJ3X81jnVvmnfyLYoEHK-BJ9uZ1f9N1ber72vlX7vamUg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2255999763</pqid></control><display><type>article</type><title>Red blood cell utilization and transfusion triggers in patients diagnosed with chronic lymphocytic leukaemia in Iceland 2003–2016</title><source>Wiley Online Library</source><creator>Thorvaldsson, Hrafn Hliddal ; Vidarsson, Brynjar ; Sveinsdottir, Signy Vala ; Olafsson, Gunnar Bjorn ; Halldorsdottir, Anna Margret</creator><creatorcontrib>Thorvaldsson, Hrafn Hliddal ; Vidarsson, Brynjar ; Sveinsdottir, Signy Vala ; Olafsson, Gunnar Bjorn ; Halldorsdottir, Anna Margret</creatorcontrib><description>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.</description><identifier>ISSN: 0042-9007</identifier><identifier>EISSN: 1423-0410</identifier><identifier>DOI: 10.1111/vox.12775</identifier><identifier>PMID: 30972770</identifier><language>eng</language><publisher>England: S. Karger AG</publisher><subject>Age ; Anemia ; Blood transfusion ; Bone marrow ; Chemotherapy ; Chronic lymphocytic leukemia ; Diagnosis ; epidemiology ; Erythrocytes ; Hemoglobin ; Leukemia ; Medical records ; Myelosuppression ; Survival ; Transfusion ; transfusion medicine (in general) ; transfusion therapy</subject><ispartof>Vox sanguinis, 2019-07, Vol.114 (5), p.495-504</ispartof><rights>2019 International Society of Blood Transfusion</rights><rights>2019 International Society of Blood Transfusion.</rights><rights>Copyright © 2019 International Society of Blood Transfusion</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3135-caadc366f958dfcf657263186c1752419e4526eb082e1b7bb7b5be20d70f28ac3</cites><orcidid>0000-0002-9464-4661</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fvox.12775$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fvox.12775$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30972770$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Thorvaldsson, Hrafn Hliddal</creatorcontrib><creatorcontrib>Vidarsson, Brynjar</creatorcontrib><creatorcontrib>Sveinsdottir, Signy Vala</creatorcontrib><creatorcontrib>Olafsson, Gunnar Bjorn</creatorcontrib><creatorcontrib>Halldorsdottir, Anna Margret</creatorcontrib><title>Red blood cell utilization and transfusion triggers in patients diagnosed with chronic lymphocytic leukaemia in Iceland 2003–2016</title><title>Vox sanguinis</title><addtitle>Vox Sang</addtitle><description>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.</description><subject>Age</subject><subject>Anemia</subject><subject>Blood transfusion</subject><subject>Bone marrow</subject><subject>Chemotherapy</subject><subject>Chronic lymphocytic leukemia</subject><subject>Diagnosis</subject><subject>epidemiology</subject><subject>Erythrocytes</subject><subject>Hemoglobin</subject><subject>Leukemia</subject><subject>Medical records</subject><subject>Myelosuppression</subject><subject>Survival</subject><subject>Transfusion</subject><subject>transfusion medicine (in general)</subject><subject>transfusion therapy</subject><issn>0042-9007</issn><issn>1423-0410</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp1kcFKHTEUhoNU9Gq78AUk0I0uRk-SSTKzFNFWEATR0t2QyWTujc4k12RGvV0V-gh9wz5JM151UWgIJAe-fDmHH6E9AkckreNH_3xEqJR8A81ITlkGOYEPaAaQ06wEkNtoJ8Y7AChowbfQNoNSJh5m6Ne1aXDded9gbboOj4Pt7A81WO-wcg0egnKxHeNUD8HO5yZEbB1eJsS4IeLGqrnzMVme7LDAehG8sxp3q3658Ho1THcz3ivTWzU9vEjfTGIKwP78_E2BiI9os1VdNJ9ez110e352c_o1u7z6cnF6cplpRhjPtFKNZkK0JS-aVreCSyoYKYQmktOclCbnVJg6DWlILeu0eW0oNBJaWijNdtHB2rsM_mE0cah6G6eplTN-jBWlIEsmCMsT-vkf9M6PwaXuEsV5WZZSsEQdrikdfIzBtNUy2F6FVUWgmpKpUjLVSzKJ3X81jnVvmnfyLYoEHK-BJ9uZ1f9N1ber72vlX7vamUg</recordid><startdate>201907</startdate><enddate>201907</enddate><creator>Thorvaldsson, Hrafn Hliddal</creator><creator>Vidarsson, Brynjar</creator><creator>Sveinsdottir, Signy Vala</creator><creator>Olafsson, Gunnar Bjorn</creator><creator>Halldorsdottir, Anna Margret</creator><general>S. Karger AG</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7T5</scope><scope>7TM</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-9464-4661</orcidid></search><sort><creationdate>201907</creationdate><title>Red blood cell utilization and transfusion triggers in patients diagnosed with chronic lymphocytic leukaemia in Iceland 2003–2016</title><author>Thorvaldsson, Hrafn Hliddal ; Vidarsson, Brynjar ; Sveinsdottir, Signy Vala ; Olafsson, Gunnar Bjorn ; Halldorsdottir, Anna Margret</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3135-caadc366f958dfcf657263186c1752419e4526eb082e1b7bb7b5be20d70f28ac3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Age</topic><topic>Anemia</topic><topic>Blood transfusion</topic><topic>Bone marrow</topic><topic>Chemotherapy</topic><topic>Chronic lymphocytic leukemia</topic><topic>Diagnosis</topic><topic>epidemiology</topic><topic>Erythrocytes</topic><topic>Hemoglobin</topic><topic>Leukemia</topic><topic>Medical records</topic><topic>Myelosuppression</topic><topic>Survival</topic><topic>Transfusion</topic><topic>transfusion medicine (in general)</topic><topic>transfusion therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Thorvaldsson, Hrafn Hliddal</creatorcontrib><creatorcontrib>Vidarsson, Brynjar</creatorcontrib><creatorcontrib>Sveinsdottir, Signy Vala</creatorcontrib><creatorcontrib>Olafsson, Gunnar Bjorn</creatorcontrib><creatorcontrib>Halldorsdottir, Anna Margret</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Immunology Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>MEDLINE - Academic</collection><jtitle>Vox sanguinis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Thorvaldsson, Hrafn Hliddal</au><au>Vidarsson, Brynjar</au><au>Sveinsdottir, Signy Vala</au><au>Olafsson, Gunnar Bjorn</au><au>Halldorsdottir, Anna Margret</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Red blood cell utilization and transfusion triggers in patients diagnosed with chronic lymphocytic leukaemia in Iceland 2003–2016</atitle><jtitle>Vox sanguinis</jtitle><addtitle>Vox Sang</addtitle><date>2019-07</date><risdate>2019</risdate><volume>114</volume><issue>5</issue><spage>495</spage><epage>504</epage><pages>495-504</pages><issn>0042-9007</issn><eissn>1423-0410</eissn><abstract>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.</abstract><cop>England</cop><pub>S. Karger AG</pub><pmid>30972770</pmid><doi>10.1111/vox.12775</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-9464-4661</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0042-9007 |
| ispartof | Vox sanguinis, 2019-07, Vol.114 (5), p.495-504 |
| issn | 0042-9007 1423-0410 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2207936134 |
| source | Wiley Online Library |
| subjects | Age Anemia Blood transfusion Bone marrow Chemotherapy Chronic lymphocytic leukemia Diagnosis epidemiology Erythrocytes Hemoglobin Leukemia Medical records Myelosuppression Survival Transfusion transfusion medicine (in general) transfusion therapy |
| title | Red blood cell utilization and transfusion triggers in patients diagnosed with chronic lymphocytic leukaemia in Iceland 2003–2016 |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-07T18%3A12%3A52IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Red%20blood%20cell%20utilization%20and%20transfusion%20triggers%20in%20patients%20diagnosed%20with%20chronic%20lymphocytic%20leukaemia%20in%20Iceland%202003%E2%80%932016&rft.jtitle=Vox%20sanguinis&rft.au=Thorvaldsson,%20Hrafn%20Hliddal&rft.date=2019-07&rft.volume=114&rft.issue=5&rft.spage=495&rft.epage=504&rft.pages=495-504&rft.issn=0042-9007&rft.eissn=1423-0410&rft_id=info:doi/10.1111/vox.12775&rft_dat=%3Cproquest_cross%3E2255999763%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2255999763&rft_id=info:pmid/30972770&rfr_iscdi=true |