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Defining Current Patterns of Blood Product Use during Intensive Induction Chemotherapy in Newly Diagnosed Acute Myeloid Leukemia Patients
INTRODUCTION: Blood product transfusion retains a critical role in the supportive care of patients with acute myeloid leukemia (AML). Whereas previous studies have shown increased transfusion dependency to portend inferior outcome, predictive factors of an increased transfusion burden and the progno...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
S. Karger AG
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10601600/ https://www.ncbi.nlm.nih.gov/pubmed/37899992 http://dx.doi.org/10.1159/000529595 |
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author | Miller, Liron Freed-Freundlich, Mor Shimoni, Avichai Hellou, Tamer Avigdor, Abraham Misgav, Mudi Canaani, Jonathan |
author_facet | Miller, Liron Freed-Freundlich, Mor Shimoni, Avichai Hellou, Tamer Avigdor, Abraham Misgav, Mudi Canaani, Jonathan |
author_sort | Miller, Liron |
collection | PubMed |
description | INTRODUCTION: Blood product transfusion retains a critical role in the supportive care of patients with acute myeloid leukemia (AML). Whereas previous studies have shown increased transfusion dependency to portend inferior outcome, predictive factors of an increased transfusion burden and the prognostic impact of transfusion support have not been assessed recently. METHODS/PATIENTS: We performed a retrospective analysis on a recent cohort of patients given intensive induction chemotherapy in 2014–2022. RESULTS: The analysis comprised 180 patients with a median age of 57 years with 80% designated as de novo AML. Fifty-four patients (31%) were FLT3-ITD mutated, and 73 patients (42%) harbored NPM1. Favorable risk and intermediate risk ELN 2017 patients accounted for 43% and 34% of patients, respectively. The median number of red blood cell (RBC) and platelet units given during induction were 9 and 7 units, respectively. Seventeen patients (9%) received cryoprecipitate, and fresh frozen plasma (FFP) was given to 12 patients (7%). Lower initial hemoglobin and platelet levels were predictive of increased use of RBC (p < 0.0001) and platelet transfusions (p < 0.0001). FFP was significantly associated with induction related mortality (42% vs. 5%; p < 0.0001) and with FLT3-ITD (72% vs. 28%; p = 0.004). Blood group AB experienced improved mean overall survival compared to blood group O patients (4.1 years vs. 2.8 years; p = 0.025). In multivariate analysis, increased number of FFP (hazard ratio [HR], 4.23; 95% confidence interval [CI], 2.1–8.6; p < 0.001) and RBC units (HR, 1.8; 95% CI, 1.2–2.8; p = 0.008) given was associated with inferior survival. CONCLUSION: Transfusion needs during induction crucially impact the clinical trajectory of AML patients. |
format | Online Article Text |
id | pubmed-10601600 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | S. Karger AG |
record_format | MEDLINE/PubMed |
spelling | pubmed-106016002023-10-27 Defining Current Patterns of Blood Product Use during Intensive Induction Chemotherapy in Newly Diagnosed Acute Myeloid Leukemia Patients Miller, Liron Freed-Freundlich, Mor Shimoni, Avichai Hellou, Tamer Avigdor, Abraham Misgav, Mudi Canaani, Jonathan Transfus Med Hemother Research Article INTRODUCTION: Blood product transfusion retains a critical role in the supportive care of patients with acute myeloid leukemia (AML). Whereas previous studies have shown increased transfusion dependency to portend inferior outcome, predictive factors of an increased transfusion burden and the prognostic impact of transfusion support have not been assessed recently. METHODS/PATIENTS: We performed a retrospective analysis on a recent cohort of patients given intensive induction chemotherapy in 2014–2022. RESULTS: The analysis comprised 180 patients with a median age of 57 years with 80% designated as de novo AML. Fifty-four patients (31%) were FLT3-ITD mutated, and 73 patients (42%) harbored NPM1. Favorable risk and intermediate risk ELN 2017 patients accounted for 43% and 34% of patients, respectively. The median number of red blood cell (RBC) and platelet units given during induction were 9 and 7 units, respectively. Seventeen patients (9%) received cryoprecipitate, and fresh frozen plasma (FFP) was given to 12 patients (7%). Lower initial hemoglobin and platelet levels were predictive of increased use of RBC (p < 0.0001) and platelet transfusions (p < 0.0001). FFP was significantly associated with induction related mortality (42% vs. 5%; p < 0.0001) and with FLT3-ITD (72% vs. 28%; p = 0.004). Blood group AB experienced improved mean overall survival compared to blood group O patients (4.1 years vs. 2.8 years; p = 0.025). In multivariate analysis, increased number of FFP (hazard ratio [HR], 4.23; 95% confidence interval [CI], 2.1–8.6; p < 0.001) and RBC units (HR, 1.8; 95% CI, 1.2–2.8; p = 0.008) given was associated with inferior survival. CONCLUSION: Transfusion needs during induction crucially impact the clinical trajectory of AML patients. S. Karger AG 2023-04-13 /pmc/articles/PMC10601600/ /pubmed/37899992 http://dx.doi.org/10.1159/000529595 Text en © 2023 The Author(s). Published by S. Karger AG, Basel https://creativecommons.org/licenses/by-nc/4.0/This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission. |
spellingShingle | Research Article Miller, Liron Freed-Freundlich, Mor Shimoni, Avichai Hellou, Tamer Avigdor, Abraham Misgav, Mudi Canaani, Jonathan Defining Current Patterns of Blood Product Use during Intensive Induction Chemotherapy in Newly Diagnosed Acute Myeloid Leukemia Patients |
title | Defining Current Patterns of Blood Product Use during Intensive Induction Chemotherapy in Newly Diagnosed Acute Myeloid Leukemia Patients |
title_full | Defining Current Patterns of Blood Product Use during Intensive Induction Chemotherapy in Newly Diagnosed Acute Myeloid Leukemia Patients |
title_fullStr | Defining Current Patterns of Blood Product Use during Intensive Induction Chemotherapy in Newly Diagnosed Acute Myeloid Leukemia Patients |
title_full_unstemmed | Defining Current Patterns of Blood Product Use during Intensive Induction Chemotherapy in Newly Diagnosed Acute Myeloid Leukemia Patients |
title_short | Defining Current Patterns of Blood Product Use during Intensive Induction Chemotherapy in Newly Diagnosed Acute Myeloid Leukemia Patients |
title_sort | defining current patterns of blood product use during intensive induction chemotherapy in newly diagnosed acute myeloid leukemia patients |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10601600/ https://www.ncbi.nlm.nih.gov/pubmed/37899992 http://dx.doi.org/10.1159/000529595 |
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