AML-192: Transfusion Reactions in Children with Acute Myeloid Leukemia in Armenia: Analysis of 20 Years of Data

• Published in: Clinical lymphoma, myeloma and leukemia myeloma and leukemia, 2020-09, Vol.20, p.S189-S189
• Main Authors: Hambardzumyan, Liana, Badikyan, Maria, Grigoryan, Hayk, Martirosyan, Nare, Evoyan, Levon, Vagharshakyan, Lala, Krmoyan, Lusine, Anastasiadi, Medea, Sargsyan, Nelli, Ter-Grigoryan, Anahit, Tamamyan, Gevorg, Danielyan, Samvel
• Format: Article
• Language: English
• Subjects: acute myeloid leukemia; AML; Armenia; children; transfusion reactions
• ISSN: 2152-2650; 2152-2669
• DOI: 10.1016/S2152-2650(20)30729-1

The incidence and severity of transfusion reactions in children with AML differ from those in adults. Published data on this problem is limited, especially from the developing world. The aim of our nationwide study was to evaluate the necessity of blood products transfusions and the incidence of transfusion reactions among children with acute myeloid leukemia (AML) during their hospitalization in Armenia between 1995 and 2014. The medical records of all children with different types of AML receiving treatment in 2 main hospitals (Hematology Center after Prof. R.H.Yeolyan and Muratsan Hospital Complex of Yerevan State Medical University) of Armenia within 20 years (1995-2014) were retrospectively reviewed and analyzed. Data of 91 pediatric patients with AML with a median age of 12 y and mean age of 10.7 y were collected. Fifty-six (61.5%) patients were male. From the entire cohort, 61 (67%) patients received RBC transfusions overall 423 times (on average 7 transfusions per patient). Information about pretransfusion Hb level was available in 132 cases: in 102 (77.3%) cases, it was below 70 g/L, in 24 (18.2%) cases, between 70 and 80 g/L, and in 6 (4.5%) cases, it was above 80 g/L. Only one transfusion reaction (chills) was documented. Platelets (PLT) were transfused to 36 (39.6%) patients: 522 (14.5 units per patient) units of whole blood platelets (WBT) were administered overall 292 times (1.8 unit per transfusion). In 149 (51%) transfusions, the pretransfusion PLT levels were below 10 × 109/L. In the entire group, WBT transfusion-related reactions were documented 2 times (1 urticaria and 1 febrile reaction with chills). Twelve packs of apheresis platelets were used and only 1 case of urticaria was reported. 286 packs (6 packs per patient) of fresh-frozen plasma (FFP) were administered to 48 (52.75%) patients. In this subgroup 10 cases of urticaria, 1 case of vomiting, and 1 febrile reaction were documented. Whole blood was transfused to 2 (2.2%) patients 4 times. In our study cohort, no life-threatening transfusion reactions were reported for any blood product transfusion, which proves that blood transfusions are quite safe in children with AML. Larger studies need to explore these findings.