Explanation and interpretation of the compilation of blood transfusion provisions for children undergoing hematopoietic stem cell transplantation in the national health standard "Guideline for pediatric transfusion"
HUANG Rong, HE Qing-Nan, HEI Ming-Yan, ZHU Xiao-Fan, LU Jun, XU Xiao-Jun, YUAN Tian-Ming, ZHANG Rong, WANG Xu, LIU Jin-Ping, WANG Jing, SHAO Zhi-Li, ZHAO Ming-Yi, GUO Yong-Jian, WU Xin-Yin, CHEN Jia-Rui, CHEN Qi-Rong, GUO Jia, GUI Rong, YANG Ming-Hua
, The Third Xiangya Hospital, Central South University Changsha 410013 China
Abstract:To guide clinical blood transfusion practices for pediatric patients, the National Health Commission has issued the health standard "Guideline for pediatric transfusion" (WS/T 795-2022). Blood transfusion for children undergoing hematopoietic stem cell transplantation is highly complex and challenging. This guideline provides recommendations on transfusion thresholds and the selection of blood components for these children. This article presents the evidence and interpretation of the transfusion provisions for children undergoing hematopoietic stem cell transplantation, with the aim of enhancing the understanding and implementation of the "Guideline for pediatric transfusion".
HUANG Rong,HE Qing-Nan,HEI Ming-Yan et al. Explanation and interpretation of the compilation of blood transfusion provisions for children undergoing hematopoietic stem cell transplantation in the national health standard "Guideline for pediatric transfusion"[J]. CJCP, 2025, 27(2): 139-143.
Avery RK, Adal KA, Longworth DL, et al. A survey of allogeneic bone marrow transplant programs in the United States regarding Cytomegalovirus prophylaxis and pre-emptive therapy[J]. Bone Marrow Transplant, 2000, 26(7): 763-767. PMID: 11042658. DOI: 10.1038/sj.bmt.1702608.
Lightdale JR, Randolph AG, Tran CM, et al. Impact of a conservative red blood cell transfusion strategy in children undergoing hematopoietic stem cell transplantation[J]. Biol Blood Marrow Transplant, 2012, 18(5): 813-817. PMID: 22080050. DOI: 10.1016/j.bbmt.2011.10.043.
Tay J, Allan DS, Chatelain E, et al. Liberal versus restrictive red blood cell transfusion thresholds in hematopoietic cell transplantation: a randomized, open label, phase III, noninferiority trial[J]. J Clin Oncol, 2020, 38(13): 1463-1473. PMID: 32083994. DOI: 10.1200/JCO.19.01836.
McPherson ME, Anderson AR, Haight AE, et al. Transfusion management of sickle cell patients during bone marrow transplantation with matched sibling donor[J]. Transfusion, 2009, 49(9): 1977-1986. PMID: 19453984. DOI: 10.1111/j.1537-2995.2009.02213.x.
Crighton GL, Estcourt LJ, Wood EM, et al. A therapeutic-only versus prophylactic platelet transfusion strategy for preventing bleeding in patients with haematological disorders after myelosuppressive chemotherapy or stem cell transplantation[J]. Cochrane Database Syst Rev, 2015, 2015(9): CD010981. PMID: 26422767. PMCID: PMC4610062. DOI: 10.1002/14651858.CD010981.pub2.
Wandt H, Schaefer-Eckart K, Wendelin K, et al. Therapeutic platelet transfusion versus routine prophylactic transfusion in patients with haematological malignancies: an open-label, multicentre, randomised study[J]. Lancet, 2012, 380(9850): 1309-1316. PMID: 22877506. DOI: 10.1016/S0140-6736(12)60689-8.
Stanworth SJ, Estcourt LJ, Powter G, et al. A no-prophylaxis platelet-transfusion strategy for hematologic cancers[J]. N Engl J Med, 2013, 368(19): 1771-1780. PMID: 23656642. DOI: 10.1056/NEJMoa1212772.
Stanworth SJ, Estcourt LJ, Llewelyn CA, et al. Impact of prophylactic platelet transfusions on bleeding events in patients with hematologic malignancies: a subgroup analysis of a randomized trial[J]. Transfusion, 2014, 54(10): 2385-2393. PMID: 24724863. DOI: 10.1111/trf.12646.
Estcourt LJ, Stanworth SJ, Doree C, et al. Comparison of different platelet count thresholds to guide administration of prophylactic platelet transfusion for preventing bleeding in people with haematological disorders after myelosuppressive chemotherapy or stem cell transplantation[J]. Cochrane Database Syst Rev, 2015, 2015(11): CD010983. PMID: 26576687. PMCID: PMC4717525. DOI: 10.1002/14651858.CD010983.pub2.
11 Cohn CS, Delaney M, Johnson ST, et al. Technical Manual[M]. 20th ed. Bethesda: American Association of Blood Banks, 2020.
Meyer SC, O'Meara A, Buser AS, et al. Prognostic impact of posttransplantation iron overload after allogeneic stem cell transplantation[J]. Biol Blood Marrow Transplant, 2013, 19(3): 440-444. PMID: 23089566. DOI: 10.1016/j.bbmt.2012.10.012.
Pullarkat V, Blanchard S, Tegtmeier B, et al. Iron overload adversely affects outcome of allogeneic hematopoietic cell transplantation[J]. Bone Marrow Transplant, 2008, 42(12): 799-805. PMID: 18762767. DOI: 10.1038/bmt.2008.262.
Maradei SC, Maiolino A, de Azevedo AM, et al. Serum ferritin as risk factor for sinusoidal obstruction syndrome of the liver in patients undergoing hematopoietic stem cell transplantation[J]. Blood, 2009, 114(6): 1270-1275. PMID: 19401560. DOI: 10.1182/blood-2009-03-212282.
Mackinnon S, Papadopoulos EB, Carabasi MH, et al. Adoptive immunotherapy evaluating escalating doses of donor leukocytes for relapse of chronic myeloid leukemia after bone marrow transplantation: separation of graft-versus-leukemia responses from graft-versus-host disease[J]. Blood, 1995, 86(4): 1261-1268. PMID: 7632930.