Platelet and red blood cell (RBC) transfusions are associated the development of acute graft-versus-host disease (aGVHD), according to a study presented at the 2021 TCT Meetings of ASTCT & CIBMTR Digital Experience.
“Transfusion therapy is a critical part of supportive care early after allogeneic hematopoietic cell transplantation (alloHCT). Platelet and RBC transfusions are known to elicit immunomodulatory effects in the recipients. Whether this impacts the risk of aGVHD has only been scarcely investigated,” the investigators wrote.
To conduct this study, researchers analyzed 664 patients who underwent myeloablative alloHCT. Patients who received haploidentical and umbilical cord blood transplants were excluded. Patients received prophylactic platelet and RBC transfusions when platelet counts were <10×109/L (<20×109/L if transplanted before 2015 or if febrile) and when hemoglobin levels were <8 g/dL, the researchers noted.
According to the results, platelet transfusion burden (from baseline to day 13) above the median was correlated with a higher cumulative incidence of subsequent grade II–IV aGVHD; the association for RBC transfusions was less clear, the investigators noted. Moreover, the results showed the cumulative number of platelet and RBC transfusions was associated with subsequent grade II–IV aGVHD.
The investigators concluded that “platelet and RBC transfusion burden in the first two weeks after myeloablative alloHCT was associated with subsequent grade II–IV aGVHD and non-relapse mortality.”
Gjaerde LK, et al. Platelet and Red Blood Cell Transfusions and Risk of Acute Graft-Versus-Host Disease after Myeloablative Allogeneic Hematopoietic Cell Transplantation. Published for the 2021 TCT Meetings of ASTCT & CIBMTR Digital Experience; February 8-12, 2021.