EVALUATION OF QUALITATIVE AND QUANTITATIVE INDICATORS OF SUBSTITUTIONARY TRANSFUSION THERAPY IN DIFFERENT TYPES OF HEMATOPOIETIC STEM CELL TRANSPLANTATION
Abstract
Relevance. Hematopoietic stem cell transplantation (HSCT) is one of methods to care patients with malignancy, hematologic and hereditary diseases; in most cases, it requires prolonged and massive substitutionary transfusion therapy. Analysis of effectiveness, cost and need for blood components in different types of HSCT would allow blood transfusion department for more accurate planning in blood output.Objective – to determine the need for blood components in different types of HSCT.Material and methods. From December 2000 to December 2015, 851 patients with malignancies, hematologic and hereditary diseases who underwent 915 HSCT (54repeatedly) were included into the study.Results. Substitutionary transfusion therapy was required in 849 HSCT (92.8% of cases Red blood cell-containing blood components were used in 842 HSCT (92%), platelet containing – in 795 HSCT (86.8%), fresh frozen plasma – in 228 HSCT (24.9%). The total number of blood transfusion in 1 case of autologous HSCT was 14.7 doses, in allogeneic HSCT – 18.5 (p=0,01). On average, transfusion therapy for one recipient of autologous HSCT cost – 57 817.4 RUB, for recipient of allogeneic HSCT – 181 710.3 RUB. The need for blood components was increased in the presence of progression/relapse of the underlying disease (p=0.0001), allogeneic HSCT compared to autologous HSCT (p=0.0001), in patients with a long history of transfusion (more than 30 blood transfusions).Conclusion. Substitutionary transfusion therapy is a key factor increasing the effectiveness of treatment with the help of HSCT by prevention and treatment of anemic syndrome and hemorrhagic complications. Allogeneic HSCT compared to autologous HSCT was associated with significantly higher financial expenditure for providing substitutionary transfusion therapy.
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