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Pediatr Blood Cancer. 2005 Feb;44(2):119-27.

Transfusion management strategies: a survey of practicing pediatric hematology/oncology specialists.

Author information

1
Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Children's National Medical Center, Washington, DC 20010, USA. ewong@cnmc.org

Abstract

BACKGROUND:

Little is known about the criteria used by pediatric oncologists for the transfusion of red blood cells and platelets to pediatric oncology patients.

PROCEDURE:

Data regarding red blood cell and platelet transfusion practices were collected with an internet-based survey of physician members of the American Society for Pediatric Hematology/Oncology (ASPH/O). Respondents were asked to define platelet and red blood cell transfusion thresholds in a variety of clinical scenarios, and to describe criteria for dealing with cytomegalovirus (CMV) transmission from blood products, platelet dosing strategies, and prevention of RhD alloimmunization.

RESULTS:

The overall response rate was 31.4% (264 of 841). Of the respondents, 76% indicated that their institution had defined criteria for acceptable transfusion practice; of these respondents, 114 (57%) indicated that there were special guidelines for pediatric oncology patients. Examination of the distribution of threshold platelet counts and hemoglobin levels that would prompt transfusion indicated a wide range of transfusion practice in commonly encountered clinical scenarios. Similar variability in practice was evident in platelet dosing strategies, CMV prevention strategies, and in the use of anti-D in RhD-negative patients who received RhD-positive platelets.

CONCLUSIONS:

This current survey demonstrates that transfusion practices vary widely among pediatric hematology/oncology specialists and that prospective clinical trials may be necessary to determine optimal criteria for blood product support in pediatric oncology patients.

PMID:
15452914
DOI:
10.1002/pbc.20159
[Indexed for MEDLINE]
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