Abstract

Objective: This study evaluates total erythrocyte, random platelet and apheresis platelet suspension requirement in pediatric acute myeloid leukemia (AML) patients in relation to ongoing chemotherapy (CT) regimens.

Material and Methods: A total of 37 pediatric patients diagnosed with AML were included in this retrospective study. Data on patient demographics (age, gender), age at diagnosis, type of CT protocol, completion of CT protocol and amount of blood product use (erythrocytes, apheresis platelet and random platelet) and survival during CT were retrieved from hospital records.

Results: The total number of erythrocytes, apheresis platelets and random platelets received by 37 AML patients from the date of diagnosis were 1275 (mean (min-max): 27 (10-102) bags), 1287(mean (min-max): 25 (-99 bags) and 1237(mean (min-max): 20 (7-139) bags), respectively. AIE as followed by maintenance treatment was associated with the highest amount of erthryocyte (p<0.001) and apheresis platelet (p<0.001) use when compared to other CT regimens, while maintenance treatment as followed by AIE was associated with the highest amount of random platelet use (p=0.008) as compared with other CT regimens. No significant difference was noted between AI and haM protocols in terms of blood product use, while apheresis platelet and random platelet use were lowest with HAM treatment (p<0.001 and p=0.008, respectively).

Conclusion: In conclusion, our findings indicate a great amount blood product transfusion to be required in children with AML under chemotherapy and emphasize the likelihood of transfusion need to alter with respect to ongoing CT regimen.

Keywords: Acute myeloblastic leukemia, child, chemotherapy, Transfusion, Blood

References

  1. Golub TRA, R.J. Acute myelogenous leukemia. In: DG PPaP, editor. Principles and Practice of Pediatric Oncology. 4 ed. Philadelphia: Lippincott Williams and Wilkins Company 2002:545-89.
  2. Margolin JF SC, Poplack DG. Acute Lymphoblastic Leukemia. In: DG PPaP, editor. Principles and Practiceof Pediatric Oncology. 4 ed: Lippincott Williams & Wilkins; 2002:489-544.
  3. Campana D, Behm FG. Immunophenotyping of leukemia. J Immunol Methods 2000;243:59-75.
  4. Heckman KD, Weiner GJ, Davis CS, Strauss RG, Jones MP, Burns CP. Randomized study of prophylactic platelet transfusion threshold during induction therapy for adult acute leukemia: 10.000/microL versus 20.000/microL. J Clin Oncol 1997;15:1143-9
  5. Rebulla P, Finazzi G, Marangoni F, Avvisati G, Gugliotta L, Tognoni G, et al. The threshold for prophylactic platelet transfusions in adults with acute myeloid leukemia. Gruppo Italiano Malattie Ematologiche Maligne dell’Adulto. N Engl J Med 1997;337:1870-5.
  6. Schiffer CA, Anderson KC, Bennett CL, Bernstein S, Elting LS, Goldsmith M, et al. Platelet transfusion for patients with cancer: clinical practice guidelines of the American Society of Clinical Oncology. J Clin Oncol 2001;19:1519-38.
  7. Wandt H, Frank M, Ehninger G, Schneider C, Brack N, Daoud A, et al. Safety and cost effectiveness of a 10 x 10(9)/L trigger for prophylactic platelet transfusions compared with the traditional 20 x 10(9)/L trigger: a prospective comparative trial in 105 patients with acute myeloid leukemia. Blood 1998;91:3601-6.
  8. Zumberg MS, del Rosario ML, Nejame CF, Pollock BH, Garzarella L, Kao KJ, et al. A prospective randomized trial of prophylactic platelet transfusion and bleeding incidence in hematopoietic stem cell transplant recipients: 10,000/L versus 20,000/microL trigger. Biol Blood Marrow Transplant 2002;8:569-76.
  9. Belson M, Kingsley B, Holmes A. Risk factors for acute leukemia in children: a review. Environ Health Perspect 2007;115:138-45.
  10. Greenlee RT, Murray T, Bolden S, Wingo PA. Cancer statistics, 2000. CA Cancer J Clin. 2000;50:7-33.
  11. Lanzkowsky P. Manuel of Pediatric Hematology and Oncology. 5 ed. New York: Elsevier; 2011.
  12. Webb DK, Harrison G, Stevens RF, Gibson BG, Hann IM, Wheatley K, et al. Relationships between age at diagnosis, clinical features, and outcome of therapy in children treated in the Medical Research Council AML 10 and 12 trials for acute myeloid leukemia. Blood 2001;98:1714-20.
  13. Kutanis A. Çocukluk Çagı Akut Lösemi Vakalarının Retrospektif Degerlendirilmesi. (Tez). İstanbul : İstanbul Bakırköy Doğumevi, Kadın ve Çocuk Hastalıkları Eğitim ve Araştırma Hastanesi, 2005.
  14. Günes AM. Türkiyede uygulanan AML sagaltım protokolleri ve sonuçları. 6 Ulusal Hematoloji Kongresi 2007:6-9.
  15. Apak H. Türkiyede uygulanan AML sağaltım protokolleri ve sonuçları: BFM AML sağaltım protokolleri. 6 Ulusal Hematoloji Kongresi 2007:92-5.
  16. Gaynon PS, Trigg ME, Heerema NA, Sensel MG, Sather HN, Hammond GD, et al. Children’s Cancer Group trials in childhood acute lymphoblastic leukemia: 1983-1995. Leukemia 2000;14:2223-33.
  17. Ribeiro RC, Razzouk BI, Pounds S, Hijiya N, Pui CH, Rubnitz JE. Successive clinical trials for childhood acute myeloid leukemia at St Jude Children’s Research Hospital, from 1980 to 2000. Leukemia 2005;19:2125-9.
  18. Cannas G, Fattoum J, Boukhit M, Thomas X. Economic analysis of blood product transfusions according to the treatment of acute myeloid leukemia in the elderly. Transfus Clin Biol 2015;22:341-7.
  19. Edlin R, Connock M, Tubeuf S, Round J, Fry-Smith A, Hyde C, Greenheld W. Azacitidine for the treatment of myelodysplastic syndrome, chronic myelomonocytic leukaemia and acute myeloid leukaemia. Health Technol Assess 2010;14:69-74.
  20. Pine AB, Lee EJ, Sekeres M, Steensma DP, Zelterman D, Prebet T, et al. Wide variations in blood product transfusion practices among providers who care for patients with acute leukemia in the United States. Transfusion 2017;57:289-95.
  21. Wilop S, Osieka R. Antineoplastic chemotherapy in Jehovah’s Witness patients with acute myelogenous leukemia refusing blood products - a matched pair analysis. Hematology 2018;23:324-9.

Copyright and license

Copyright © 2020 The Author(s). This is an open access article distributed under the Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.

How to cite

1.
Güdeloğlu E, Albayrak D, Albayrak D. Blood Product Requirement in Childhood Acute Myeloid Leukemia by Chemotherapy Regimens. Turk J Pediatr Dis [Internet]. 2020 Nov. 30 [cited 2025 Aug. 23];14(6):507-11. Available from: https://turkjpediatrdis.org/article/view/648