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THE EFFICACY IN THE USE OF BLOOD TRANSFUSSION IN MANAGING HAEMATOLOGICAL DISEASES
CHAPTER ONE
INTRODUCTION
Background of the study
Randomized clinical trials (RCTs) have determined, in surgical and critically ill patients, relatively safe hemoglobin (Hb) thresholds of 7-8 g/dL to guide restrictive transfusion of red blood cells (RBCs). However, in patients with various hematologic disorders, strong evidence in support of such an approach is sparse and the optimal transfusion practice is yet to be defined. This review focuses on RBC transfusion practice in three hematologic diseases and a treatment strategy, including autoimmune hemolytic anemia, thalassemia, myelodysplastic syndrome, and hematopoietic stem cell transplantation. These entities manifest in a broad spectrum of anemia, acute or chronic, in patients with different comorbidities and degrees of transfusion requirement. Thus the nuances in the indications of RBC transfusion and the goals to achieve in these specific situations may have been underappreciated.
1.2 Statement of the problem
The limited data available highlight the importance of titrating RBC transfusion based on the clinical context and patient characteristics is a challenge. Future RCTs are necessary to firmly establish the Hb thresholds associated with improved outcomes relevant to these specific patient populations, which will facilitate the personalized decision-making in RBC transfusion.
1.3 Learning Objectives
● To understand the evidence supporting the current transfusion practice and its limitations in patients with hematologic disorders and anemia resulting from therapy
● To understand the goal(s) of red blood cell transfusion in patients with representative hematologic disorders and anemia resulting from therapy
1.4 Research Questions
1. What is the evidence supporting the current transfusion practice and its limitations in patients with hematologic disorders and anemia resulting from therapy
2. What are the goal(s) of red blood cell transfusion in patients with representative hematologic disorders and anemia resulting from therapy
1.5 Research hypothesis
H0: There is no significant impact of use of blood transfusion on patients with haematological diseases
H1: There is a significant impact of use of blood transfusion on patients with haematological diseases
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