Pediatric hematology/oncology patients receive a significant proportion of pediatric transfusions. Data, however, are limited guiding clinical decisions for transfusions in this patient population. To better understand current transfusion practices for pediatric patients with cancers and those needing hematopoietic stem cell transplants (HSCT), researchers retrospectively analyzed data collected between 2013 and 2016 for the National Heart and Lung and Blood Institute (NHLBI) Recipient Epidemiology and Donor Evaluation Study-III (REDS-III). A total of 4766 inpatient encounters among 632 oncology and HSCT pediatric patients were evaluated; 39.3% of these encounters required at least one transfusion. RBCs were the most common blood product transfused (32.4% of encounters) followed by platelets (22.7%); plasma was only transfused in 2.4% of encounters. Both RBCs and platelets were transfused in 37% of encounters requiring transfusions. The median pre-RBC-transfusion hemoglobin value for inpatients was 7.5 g/dL, the median platelet count pre-platelet transfusion was 20 X 109/L, and the median INR pre-plasma transfusion was 1.7. These pre-transfusion laboratory values—relatively high for hemoglobin and platelets and relatively low for INR vales—highlight the need for a better understanding and guidelines for transfusions in pediatric oncology patients.
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