An analysis of transfusion support in haematopoietic stem cell transplantation – report from a centre in India Suvro Sankha Datta *, Sabita Basu, Mammen Chandy Department of Transfusion Medicine, TATA Medical Center, Kolkata, West Bengal, India A R T I C L E I N FO Article history: Received 14 April 2015 Received in revised form 2 May 2015 Accepted 10 July 2015 Keywords: Haematopoietic stem cell transplantation Matched related donor Matched unrelated donor ABO compatibility Transfusion support GvHD A B ST R AC T Background: Transfusion support in haematopoietic stem cell transplantation (HSCT) can be very demanding and challenging. The conditioning regimen, stem cell dose, donor type, presence of GvHD, infection all influence transfusion therapy in haematopoietic stem cell transplantation (HSCT). We retrospectively analysed the first 100 days transfusion require- ments among HSCT recipients with haematological as well as non-haematological malignancies in our centre. Materials and Methods: Transfusion data were retrieved for 100 patients who had under- gone HSCT over a period of two years. The HSCT recipients were divided into three groups: autologous, allogenic and haplo-identical. Allogenic group was subdivided into matched related donor (MRD) and matched unrelated donor (MUD). The allo and haplo groups were then classified on the basis of the ABO compatibility as major, minor, bi-directional and compatible. We analysed the mean requirement of blood components (RBC, RDP, SDP and FFP) within the first 100 days of HSCT in each category. Results and Discussion: Haematologic malignancies constituted 97% of the indications for HSCT. Allo-HSCT constituted 50% of the HSCT, of which 92% were MRD. Auto and haplo- HSCT constituted 40% and 10% respectively. Mean requirement for all products – RBC, SDP, RDP and FFP – was highest in the haplo category, followed by the allo category and then the auto HSCT category. The mean product requirement in the MUD category was signifi- cantly higher than in the MRD category (p < 0.05). The mean product requirement in the major and bidirectional ABO incompatible group was significantly higher as compared to the minor and ABO compatible group (p < 0.05). Hence our data may help transfusion medicine specialists to understand the transfu- sion requirement in stem cell transplant settings from developing countries like India. The average number of blood donors required for each group of stem cell transplant patients can also be roughly predicted from this study. © 2015 Elsevier Ltd. All rights reserved. 1. Introduction Haematopoietic stem cell transplantation (HSCT) is a po- tentially curative treatment for many patients with haematological as well as non-haematological malignan- cies. Transfusion support in haematopoietic stem cell transplantation (HSCT) can be very demanding and chal- lenging. The conditioning regimen, stem cell dose, donor type, presence of GvHD, infection all influence transfusion therapy. Patients are usually dependent on blood products until en- graftment of stem cells. Previously high-dose conditioning regimens have been used for disease eradiation and im- munosuppression in HSCT [1]. But due to high toxicity of myeloablative regimen, the uses of nonmyeloablative and reduced intensity regimens (RIC) have been started for the conditioning. Conventional myeloablative conditioning con- sisted of cyclophosphamide and total body irradiation, cyclophosphamide/total body irradiation and etoposide, or * Corresponding author. Department of Transfusion Medicine, TATA Medical Center, 14, Main Arterial road, Newtown, Rajarhat, Kolkata 700156, West Bengal, India. Tel.: +91 9434027705; fax: +91 03422540071. E-mail address: suvro.datta@gmail.com (S.S. Datta). http://dx.doi.org/10.1016/j.transci.2015.07.006 1473-0502/© 2015 Elsevier Ltd. All rights reserved. Transfusion and Apheresis Science 53 (2015) 373–377 Contents lists available at ScienceDirect Transfusion and Apheresis Science journal homepage: www.elsevier.com/locate/transci