Efficacy of packed red blood cell transfusions based on weight versus formula in thalassemic children: An open‐label randomized control trial

• Published in: Transfusion (Philadelphia, Pa.) Vol. 62; no. 4; pp. 791 - 796
• Main Authors: Kaur, Mehakdeep, Kaur, Ravneet, Sood, Tanvi, Jindal, Geetanjali, Kaur, Paramjit, Mittal, Kshitija
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.04.2022; Wiley Subscription Services, Inc
• Subjects: Blood transfusion; Blood Transfusion - methods; Child; Child, Preschool; Children; DNA nucleotidylexotransferase; Erythrocyte Transfusion - methods; Erythrocytes; Erythrocytes - chemistry; Health care facilities; Hematocrit; Hemoglobin; Hemoglobins - analysis; Humans; Mathematical analysis; Patients; Thalassemia; Transfusion; transfusion guidelines; transfusion volume; transfusion‐dependent thalassemia (TDT); Weight; transfusion volume; transfusion guidelines; transfusion-dependent thalassemia (TDT)
• ISSN: 0041-1132; 1537-2995; 1537-2995
• DOI: 10.1111/trf.16840

Background Protocols for transfusion therapy in transfusion‐dependent thalassemia (TDT) children differ among various medical centers. In India, most centers consider only the patient's weight while calculating the volume of packed red blood cells (PRBCs) to be transfused. This study aimed to compare the efficacy of PRBC transfusions of different volumes calculated either by weight or by a formula using weight and pretransfusion hemoglobin of patient and hematocrit of PRBC. Study Design and Methods Sixty TDT patients in the age group of 3–9 years were enrolled and randomly allocated to two groups. Group A received PRBC transfusion volume based on the patient's weight, and Group B received PRBC volume calculated using a formula for 6 months. Results Average pretransfusion hemoglobin in Group A and Group B (9 ± 0.4 vs. 8.9 ± 0.4 g/dl) was not significantly different (p = .353). Although the average number of visits in 6 months was less for Group A compared to Group B (7 ± 1 vs. 8 ± 1; p = .001); the average volume transfused per visit was more (351 ± 78 vs. 287 ± 68 ml; p = .003). The calculated average annual pure red cell requirement of the patients was 178 ml/kg/year for Group A and 154 ml/kg/year for Group B (p = .000). Total donor exposures were significantly lower in Group B than Group A (11 ± 3 vs. 14 ± 3; p = .006). Conclusion The number of donor exposures and annual pure red cell requirement was significantly lower in the formula‐based group. Transfusions based on formula are recommended in TDT patients.