Is the number of blood products transfused associated with lower survival in children with acute lymphoblastic leukemia?
Background Blood transfusion during acute lymphoblastic leukemia (ALL) of childhood is scarcely documented. Children with ALL are immunosuppressed by both the disease and its therapy. Transfusion may contribute to the course of ALL through its transfusion‐related immunomodulation (TRIM) effect. Proc...
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| Veröffentlicht in: | Pediatric blood & cancer 2011-08, Vol.57 (2), p.217-223 |
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| creator | Jaime-Pérez, José Carlos Colunga-Pedraza, Perla R. Gómez-Almaguer, David |
| description | Background
Blood transfusion during acute lymphoblastic leukemia (ALL) of childhood is scarcely documented. Children with ALL are immunosuppressed by both the disease and its therapy. Transfusion may contribute to the course of ALL through its transfusion‐related immunomodulation (TRIM) effect.
Procedure
Blood transfusion history and response to therapy for 108 children 5 packed red blood cells (PRBC) remained a significant predictor for death (P = 0.003) and relapse (P = 0.011). For platelets, maximal significance was observed when >30 platelet concentrates (PC) were transfused (P 30 blood products (P |
| doi_str_mv | 10.1002/pbc.22957 |
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| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_871968665</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1020838186</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3957-60175ed646d221623e66b2f01c5b55efe3ff645f245f40ec762a38773051abde3</originalsourceid><addsrcrecordid>eNp9kUtv1DAUhS0Eog9Y8AeQd9BFWj9iJ7NCZQSlVVsQKoKd5TjXGlMnHuy40_n3GNLODhaWr3S_c3SPDkKvKDmmhLCTdWeOGVuI5gnap6IWlSC0ebqbyWIPHaT0s6CSiPY52mNUNpSLxT66P094WgEe89BBxMHizofQ43UMfTZTWUY9JpsT9FinFIzTUxk3blphHzZFknK8c3faYzdis3K-jzDOe23yBNhvh_UqdF6nyRnsId_C4PS7F-iZ1T7By4f_EH37-OFm-am6_Hx2vjy9rAwvgSpZkgjoZS17Vq5mHKTsmCXUiE4IsMCtlbWwrLyagGkk07xtGk4E1V0P_BC9mX1Lol8Z0qQGlwx4r0cIOam2oQvZSikK-fa_JCWMtLylrSzo0YyaGFKKYNU6ukHHbYHUn0pUqUT9raSwrx9sczdAvyMfOyjAyQxsnIftv53Ul_fLR8tqVrg0wf1OoeOtkg1vhPp-faauLr5e1DfXV-oH_w2sLaYQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1020838186</pqid></control><display><type>article</type><title>Is the number of blood products transfused associated with lower survival in children with acute lymphoblastic leukemia?</title><source>MEDLINE</source><source>Wiley Journals</source><creator>Jaime-Pérez, José Carlos ; Colunga-Pedraza, Perla R. ; Gómez-Almaguer, David</creator><creatorcontrib>Jaime-Pérez, José Carlos ; Colunga-Pedraza, Perla R. ; Gómez-Almaguer, David</creatorcontrib><description>Background
Blood transfusion during acute lymphoblastic leukemia (ALL) of childhood is scarcely documented. Children with ALL are immunosuppressed by both the disease and its therapy. Transfusion may contribute to the course of ALL through its transfusion‐related immunomodulation (TRIM) effect.
Procedure
Blood transfusion history and response to therapy for 108 children <16 years of age at the time of ALL diagnosis was documented. Clinical files, electronic records, and blood bank registries were scrutinized. Overall survival (OS) and event‐free survival (EFS) in relation to blood product type and number of transfusions was determined. Hazard ratios (HR) for death and relapse were estimated through uni‐ and multivariate Cox regression analysis.
Results
One hundred eight ALL patients were included. Median age was 6 years (range: 0–15 years). Ninety‐seven patients (89.8%) were transfused. Median number of transfused products was seven (range: 0‐345). After multivariate analysis, transfusion of >5 packed red blood cells (PRBC) remained a significant predictor for death (P = 0.003) and relapse (P = 0.011). For platelets, maximal significance was observed when >30 platelet concentrates (PC) were transfused (P < 0.001). When both, PRBC and PC were considered, maximal significance for predicting death was observed with transfusion of >30 blood products (P < 0.001).
Conclusions
The number of blood products transfused to children with ALL appears to be significantly associated with lower survival rates. This may reflect both the severity of the disease and the TRIM effect, which may decrease immune surveillance capacity and the probability of leukemic clone eradication. Pediatr Blood Cancer 2011; 57: 217–223. © 2011 Wiley‐Liss, Inc.</description><identifier>ISSN: 1545-5009</identifier><identifier>ISSN: 1545-5017</identifier><identifier>EISSN: 1545-5017</identifier><identifier>DOI: 10.1002/pbc.22957</identifier><identifier>PMID: 21671359</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>Acute lymphatic leukemia ; acute lymphoblastic leukemia ; Adolescent ; Age ; Blood products ; Blood transfusion ; Blood Transfusion - methods ; Cancer ; Child ; Child, Preschool ; Children ; Chimerism ; Disease-Free Survival ; Erythrocytes ; Humans ; Immunomodulation ; Immunosurveillance ; Infant ; Infant, Newborn ; Leukocyte Reduction Procedures ; leukoreduction ; microchimerism ; Multivariate Analysis ; Platelets ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - immunology ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy ; Proportional Hazards Models ; Regression analysis ; Retrospective Studies ; Survival ; Survival Analysis ; Transfusion Reaction ; transfusion-related immunomodulation</subject><ispartof>Pediatric blood & cancer, 2011-08, Vol.57 (2), p.217-223</ispartof><rights>Copyright © 2011 Wiley‐Liss, Inc.</rights><rights>Copyright © 2011 Wiley-Liss, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3957-60175ed646d221623e66b2f01c5b55efe3ff645f245f40ec762a38773051abde3</citedby><cites>FETCH-LOGICAL-c3957-60175ed646d221623e66b2f01c5b55efe3ff645f245f40ec762a38773051abde3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fpbc.22957$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fpbc.22957$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21671359$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jaime-Pérez, José Carlos</creatorcontrib><creatorcontrib>Colunga-Pedraza, Perla R.</creatorcontrib><creatorcontrib>Gómez-Almaguer, David</creatorcontrib><title>Is the number of blood products transfused associated with lower survival in children with acute lymphoblastic leukemia?</title><title>Pediatric blood & cancer</title><addtitle>Pediatr. Blood Cancer</addtitle><description>Background
Blood transfusion during acute lymphoblastic leukemia (ALL) of childhood is scarcely documented. Children with ALL are immunosuppressed by both the disease and its therapy. Transfusion may contribute to the course of ALL through its transfusion‐related immunomodulation (TRIM) effect.
Procedure
Blood transfusion history and response to therapy for 108 children <16 years of age at the time of ALL diagnosis was documented. Clinical files, electronic records, and blood bank registries were scrutinized. Overall survival (OS) and event‐free survival (EFS) in relation to blood product type and number of transfusions was determined. Hazard ratios (HR) for death and relapse were estimated through uni‐ and multivariate Cox regression analysis.
Results
One hundred eight ALL patients were included. Median age was 6 years (range: 0–15 years). Ninety‐seven patients (89.8%) were transfused. Median number of transfused products was seven (range: 0‐345). After multivariate analysis, transfusion of >5 packed red blood cells (PRBC) remained a significant predictor for death (P = 0.003) and relapse (P = 0.011). For platelets, maximal significance was observed when >30 platelet concentrates (PC) were transfused (P < 0.001). When both, PRBC and PC were considered, maximal significance for predicting death was observed with transfusion of >30 blood products (P < 0.001).
Conclusions
The number of blood products transfused to children with ALL appears to be significantly associated with lower survival rates. This may reflect both the severity of the disease and the TRIM effect, which may decrease immune surveillance capacity and the probability of leukemic clone eradication. Pediatr Blood Cancer 2011; 57: 217–223. © 2011 Wiley‐Liss, Inc.</description><subject>Acute lymphatic leukemia</subject><subject>acute lymphoblastic leukemia</subject><subject>Adolescent</subject><subject>Age</subject><subject>Blood products</subject><subject>Blood transfusion</subject><subject>Blood Transfusion - methods</subject><subject>Cancer</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Chimerism</subject><subject>Disease-Free Survival</subject><subject>Erythrocytes</subject><subject>Humans</subject><subject>Immunomodulation</subject><subject>Immunosurveillance</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Leukocyte Reduction Procedures</subject><subject>leukoreduction</subject><subject>microchimerism</subject><subject>Multivariate Analysis</subject><subject>Platelets</subject><subject>Precursor Cell Lymphoblastic Leukemia-Lymphoma - immunology</subject><subject>Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy</subject><subject>Proportional Hazards Models</subject><subject>Regression analysis</subject><subject>Retrospective Studies</subject><subject>Survival</subject><subject>Survival Analysis</subject><subject>Transfusion Reaction</subject><subject>transfusion-related immunomodulation</subject><issn>1545-5009</issn><issn>1545-5017</issn><issn>1545-5017</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUtv1DAUhS0Eog9Y8AeQd9BFWj9iJ7NCZQSlVVsQKoKd5TjXGlMnHuy40_n3GNLODhaWr3S_c3SPDkKvKDmmhLCTdWeOGVuI5gnap6IWlSC0ebqbyWIPHaT0s6CSiPY52mNUNpSLxT66P094WgEe89BBxMHizofQ43UMfTZTWUY9JpsT9FinFIzTUxk3blphHzZFknK8c3faYzdis3K-jzDOe23yBNhvh_UqdF6nyRnsId_C4PS7F-iZ1T7By4f_EH37-OFm-am6_Hx2vjy9rAwvgSpZkgjoZS17Vq5mHKTsmCXUiE4IsMCtlbWwrLyagGkk07xtGk4E1V0P_BC9mX1Lol8Z0qQGlwx4r0cIOam2oQvZSikK-fa_JCWMtLylrSzo0YyaGFKKYNU6ukHHbYHUn0pUqUT9raSwrx9sczdAvyMfOyjAyQxsnIftv53Ul_fLR8tqVrg0wf1OoeOtkg1vhPp-faauLr5e1DfXV-oH_w2sLaYQ</recordid><startdate>201108</startdate><enddate>201108</enddate><creator>Jaime-Pérez, José Carlos</creator><creator>Colunga-Pedraza, Perla R.</creator><creator>Gómez-Almaguer, David</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>201108</creationdate><title>Is the number of blood products transfused associated with lower survival in children with acute lymphoblastic leukemia?</title><author>Jaime-Pérez, José Carlos ; Colunga-Pedraza, Perla R. ; Gómez-Almaguer, David</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3957-60175ed646d221623e66b2f01c5b55efe3ff645f245f40ec762a38773051abde3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Acute lymphatic leukemia</topic><topic>acute lymphoblastic leukemia</topic><topic>Adolescent</topic><topic>Age</topic><topic>Blood products</topic><topic>Blood transfusion</topic><topic>Blood Transfusion - methods</topic><topic>Cancer</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Chimerism</topic><topic>Disease-Free Survival</topic><topic>Erythrocytes</topic><topic>Humans</topic><topic>Immunomodulation</topic><topic>Immunosurveillance</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Leukocyte Reduction Procedures</topic><topic>leukoreduction</topic><topic>microchimerism</topic><topic>Multivariate Analysis</topic><topic>Platelets</topic><topic>Precursor Cell Lymphoblastic Leukemia-Lymphoma - immunology</topic><topic>Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy</topic><topic>Proportional Hazards Models</topic><topic>Regression analysis</topic><topic>Retrospective Studies</topic><topic>Survival</topic><topic>Survival Analysis</topic><topic>Transfusion Reaction</topic><topic>transfusion-related immunomodulation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jaime-Pérez, José Carlos</creatorcontrib><creatorcontrib>Colunga-Pedraza, Perla R.</creatorcontrib><creatorcontrib>Gómez-Almaguer, David</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric blood & cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jaime-Pérez, José Carlos</au><au>Colunga-Pedraza, Perla R.</au><au>Gómez-Almaguer, David</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Is the number of blood products transfused associated with lower survival in children with acute lymphoblastic leukemia?</atitle><jtitle>Pediatric blood & cancer</jtitle><addtitle>Pediatr. Blood Cancer</addtitle><date>2011-08</date><risdate>2011</risdate><volume>57</volume><issue>2</issue><spage>217</spage><epage>223</epage><pages>217-223</pages><issn>1545-5009</issn><issn>1545-5017</issn><eissn>1545-5017</eissn><abstract>Background
Blood transfusion during acute lymphoblastic leukemia (ALL) of childhood is scarcely documented. Children with ALL are immunosuppressed by both the disease and its therapy. Transfusion may contribute to the course of ALL through its transfusion‐related immunomodulation (TRIM) effect.
Procedure
Blood transfusion history and response to therapy for 108 children <16 years of age at the time of ALL diagnosis was documented. Clinical files, electronic records, and blood bank registries were scrutinized. Overall survival (OS) and event‐free survival (EFS) in relation to blood product type and number of transfusions was determined. Hazard ratios (HR) for death and relapse were estimated through uni‐ and multivariate Cox regression analysis.
Results
One hundred eight ALL patients were included. Median age was 6 years (range: 0–15 years). Ninety‐seven patients (89.8%) were transfused. Median number of transfused products was seven (range: 0‐345). After multivariate analysis, transfusion of >5 packed red blood cells (PRBC) remained a significant predictor for death (P = 0.003) and relapse (P = 0.011). For platelets, maximal significance was observed when >30 platelet concentrates (PC) were transfused (P < 0.001). When both, PRBC and PC were considered, maximal significance for predicting death was observed with transfusion of >30 blood products (P < 0.001).
Conclusions
The number of blood products transfused to children with ALL appears to be significantly associated with lower survival rates. This may reflect both the severity of the disease and the TRIM effect, which may decrease immune surveillance capacity and the probability of leukemic clone eradication. Pediatr Blood Cancer 2011; 57: 217–223. © 2011 Wiley‐Liss, Inc.</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>21671359</pmid><doi>10.1002/pbc.22957</doi><tpages>7</tpages></addata></record> |
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| subjects | Acute lymphatic leukemia acute lymphoblastic leukemia Adolescent Age Blood products Blood transfusion Blood Transfusion - methods Cancer Child Child, Preschool Children Chimerism Disease-Free Survival Erythrocytes Humans Immunomodulation Immunosurveillance Infant Infant, Newborn Leukocyte Reduction Procedures leukoreduction microchimerism Multivariate Analysis Platelets Precursor Cell Lymphoblastic Leukemia-Lymphoma - immunology Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy Proportional Hazards Models Regression analysis Retrospective Studies Survival Survival Analysis Transfusion Reaction transfusion-related immunomodulation |
| title | Is the number of blood products transfused associated with lower survival in children with acute lymphoblastic leukemia? |
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