The Clinic Observation Of Red Blood Cell Transfusion In Patients With Bone Marrow Failure

Background:Bone marrow failure syndromes(BMFS)is a group of hematopoetic disease with hypoplasia.Hematopoietic stem cell transplantation is expected to be a cure method for the disease.However,only few patients reveived HSCT because of the hardness for HLA-matched donor,high cost and mortality of transplantation.Thus,supportive treatment,especially blood cell transfusion,still be an important treatment for patients with BMFS.A growing studies suggested that the efficacy of red blood cell(RBC)transfusion should be pay more attentions in clinical application.Objective:To evaluate the influence factors on red blood cell tansfusion efficacy by measuring the hemoglobin increment in patiens with BMFS.The correlation between the prognosis and the tansfusion efficacy has been analyzed subsequently.Then,we aimed to gain more insight and knowledge about red blood cell transfusion practices in patients with BMFS.Methods:Using retrospective analysis,we studied the red blood c ell transfusion of 68 BMFS and its relationship with factors,including gender,age,disease type,nationality,blood type,any bleeding,liver and spleen enlargement,ferritin level,height,weight,history of preg nancy,whetherinfection,blood transfusion amount,number of blood tr ansfusions,ECOG score,KPS score.That wether the prognosis of th ese 43 BMFS patients is related to the efficacy of blood transfusion is studied at the same time.Multivariate stepwise regression analysis was used to screen out the factors affecting the efficacy of RBC tran sfusion in patients,and the correlation analysis was used to confirm t he results.Kaplan-meier method was used to analyze the survival of the ineffective transfusion group,and p<0.05 was considered statistic ally significant.Results:68 patients with BMFS received 191 transfusions of RBC suspension,91 of which were effective transfusions,accounting for 47.64%.After multiple stepwise regression analysis,it suggested that the efficacy of RBC transfusion may be affected by these five factors in patients with BMFS,such as infection,KPS score,bleeding,ethnicity and body surface area(BSA).The efficacy of RBC transfusion in BMFS patients with infection was significantly lower than that without infection.BMFS patients who have no bleeding manifestations or smaller BSA(<1.7m~2)showed significantly higher efficacy during RBC transfusion.However,the efficacy of RBC transfusion in BMFS patients with different ethnicity and KPS score showed no significant different(P>0.05).Survival of BMFS patients with ineffective or effective RBC transfusion didn't showed obvious difference.Conclusion:There are many factors affecting the ineffectiveness of RBC transfusion in clinical,mainly related to the presence or abse nce of infection,or absence of bleeding and body surface area.In th is study,the survival of patients with BMFS was not associated with the efficacy of red blood cell transfusion,but was associated with t heir own disease type.