Explanation and interpretation of blood transfusion provisions for children with hematological diseases in the national health standard "Guideline for pediatric transfusion"

ZHAO Ming-Yi, HUANG Rong, GUI 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, GUO Yong-Jian, WU Xin-Yin, CHEN Jia-Rui, CHEN Qi-Rong, GUO Jia, YANG Ming-Hua

Chinese Journal of Contemporary Pediatrics ›› 2025, Vol. 27 ›› Issue (1) : 18-25.

PDF(592 KB)
HTML
PDF(592 KB)
HTML
Chinese Journal of Contemporary Pediatrics ›› 2025, Vol. 27 ›› Issue (1) : 18-25. DOI: 10.7499/j.issn.1008-8830.2410093
GUIDELINE INTERPRETATION: GUIDELINE FOR PEDIATRIC TRANSFUSION

Explanation and interpretation of blood transfusion provisions for children with hematological diseases in the national health standard "Guideline for pediatric transfusion"

  • ZHAO Ming-Yi, HUANG Rong, GUI 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, GUO Yong-Jian, WU Xin-Yin, CHEN Jia-Rui, CHEN Qi-Rong, GUO Jia, YANG Ming-Hua
Author information +
History +

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 is one of the most commonly used supportive treatments for children with hematological diseases. This guideline provides guidance and recommendations for blood transfusions in children with aplastic anemia, thalassemia, autoimmune hemolytic anemia, glucose-6-phosphate dehydrogenase deficiency, acute leukemia, myelodysplastic syndromes, immune thrombocytopenic purpura, and thrombotic thrombocytopenic purpura. This article presents the evidence and interpretation of the blood transfusion provisions for children with hematological diseases in the "Guideline for pediatric transfusion", aiming to assist in the understanding and implementing the blood transfusion section of this guideline.

Key words

Aplastic anemia / Thalassemia / Autoimmune hemolytic anemia / Acute leukemia / Thrombocytopenia / Child

Cite this article

Download Citations
ZHAO Ming-Yi, HUANG Rong, GUI 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, GUO Yong-Jian, WU Xin-Yin, CHEN Jia-Rui, CHEN Qi-Rong, GUO Jia, YANG Ming-Hua. Explanation and interpretation of blood transfusion provisions for children with hematological diseases in the national health standard "Guideline for pediatric transfusion"[J]. Chinese Journal of Contemporary Pediatrics. 2025, 27(1): 18-25 https://doi.org/10.7499/j.issn.1008-8830.2410093

References

1 中华人民共和国国家卫生健康委员会法规司. 关于发布《输血相容性检测标准》等3项推荐性卫生行业标准的通告: 国卫通〔2022〕1号[EB/OL]. (2022-02-23)[2022-09-01]. http://www.nhc.gov.cn/fzs/s7852d/202202/1484f47dcf824ee8bae3ad7b6809e603.shtml.
2 Case RB, Berglund E, Sarnoff SJ. Ventricular function. VII. Changes in coronary resistance and ventricular function resulting from acutely induced anemia and the effect thereon of coronary stenosis[J]. Am J Med, 1955, 18(3): 397-405. PMID: 14349964. DOI: 10.1016/0002-9343(55)90219-9.
3 Yawn BP, Buchanan GR, Afenyi-Annan AN, et al. Management of sickle cell disease: summary of the 2014 evidence-based report by expert panel members[J]. JAMA, 2014, 312(10): 1033-1048. PMID: 25203083. DOI: 10.1001/jama.2014.10517.
4 New HV, Berryman J, Bolton-Maggs PH, et al. Guidelines on transfusion for fetuses, neonates and older children[J]. Br J Haematol, 2016, 175(5): 784-828. PMID: 27861734. DOI: 10.1111/bjh.14233.
5 Sagmeister M, Oec L, Gmür J. A restrictive platelet transfusion policy allowing long-term support of outpatients with severe aplastic anemia[J]. Blood, 1999, 93(9): 3124-3126. PMID: 10216111.
6 Estcourt L, Stanworth S, Doree C, et al. Prophylactic platelet transfusion for prevention of bleeding in patients with haematological disorders after chemotherapy and stem cell transplantation[J]. Cochrane Database Syst Rev, 2012(5): CD004269. PMID: 22592695. DOI: 10.1002/14651858.CD004269.pub3.
7 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.
8 Killick SB, Bown N, Cavenagh J, et al. Guidelines for the diagnosis and management of adult aplastic anaemia[J]. Br J Haematol, 2016, 172(2): 187-207. PMID: 26568159. DOI: 10.1111/bjh.13853.
9 Taher A, Vichinsky E, Musallam K, et al. Guidelines for the management of non transfusion dependent thalassaemia (NTDT): 2nd edition[EB/OL]. [2021-08-06]. https://thalassaemia.org.cy/wp-content/uploads/2017/10/NTDT-final-combined-1.pdf.
10 Cappellini MD, Farmakis D, Porter J, et al. 2021 Guidelines for the management of transfusion dependent thalassaemia (TDT): 4th edition[EB/OL]. [2021-08-06]. https://www.thalassemia.org/wp-content/uploads/2021/06/TIF-2021-Guidelines-for-Mgmt-of-TDT.pdf.
11 Taher AT, Musallam KM, Cappellini MD, et al. Optimal management of β thalassaemia intermedia[J]. Br J Haematol, 2011, 152(5): 512-523. PMID: 21250971. DOI: 10.1111/j.1365-2141.2010.08486.x.
12 Karimi M, Musallam KM, Cappellini MD, et al. Risk factors for pulmonary hypertension in patients with β thalassemia intermedia[J]. Eur J Intern Med, 2011, 22(6): 607-610. PMID: 22075289. DOI: 10.1016/j.ejim.2011.05.013.
13 Taher A, Isma'eel H, Mehio G, et al. Prevalence of thromboembolic events among 8,860 patients with thalassaemia major and intermedia in the Mediterranean area and Iran[J]. Thromb Haemost, 2006, 96(4): 488-491. PMID: 17003927.
14 Taher AT, Musallam KM, Karimi M, et al. Overview on practices in thalassemia intermedia management aiming for lowering complication rates across a region of endemicity: the OPTIMAL CARE study[J]. Blood, 2010, 115(10): 1886-1892. PMID: 20032507. DOI: 10.1182/blood-2009-09-243154.
15 Taher AT, Musallam KM, Nasreddine W, et al. Asymptomatic brain magnetic resonance imaging abnormalities in splenectomized adults with thalassemia intermedia[J]. J Thromb Haemost, 2010, 8(1): 54-59. PMID: 19817994. DOI: 10.1111/j.1538-7836.2009.03651.x.
16 Haidar R, Mhaidli H, Taher AT. Paraspinal extramedullary hematopoiesis in patients with thalassemia intermedia [J]. Eur Spine J, 2010, 19(6): 871-878. PMID: 20204423. PMCID: PMC2899982. DOI: 10.1007/s00586-010-1357-2.
17 Musallam KM, Taher AT, Karimi M, et al. Cerebral infarction in β-thalassemia intermedia: breaking the silence[J]. Thromb Res, 2012, 130(5): 695-702. PMID: 22857801. DOI: 10.1016/j.thromres.2012.07.013.
18 Sankaran J, Rodriguez V, Jacob EK, et al. Autoimmune hemolytic anemia in children: mayo clinic experience[J]. J Pediatr Hematol Oncol, 2016, 38(3): e120-e124. PMID: 26925716. DOI: 10.1097/MPH.0000000000000542.
19 Cohn CS, Delaney M, Johnson ST, et al. Technical Manual[M]. 20th ed. Bethesda: American Association of Blood Banks, 2020.
20 Salama A, Bergh?fer H, Mueller-Eckhardt C. Red blood cell transfusion in warm-type autoimmune haemolytic anaemia[J]. Lancet, 1992, 340(8834/8835): 1515-1517. PMID: 1361607. DOI: 10.1016/0140-6736(92)92766-9.
21 Ladogana S, Maruzzi M, Samperi P, et al. Diagnosis and management of newly diagnosed childhood autoimmune haemolytic anaemia. Recommendations from the Red Cell Study Group of the Paediatric Haemato-Oncology Italian Association[J]. Blood Transfus, 2017, 15(3): 259-267. PMID: 28151390. PMCID: PMC5448833. DOI: 10.2450/2016.0072-16.
22 Padmanabhan A, Connelly-Smith L, Aqui N, et al. Guidelines on the use of therapeutic apheresis in clinical practice—evidence-based approach from the Writing Committee of the American Society for Apheresis: The Eighth Special Issue[J]. J Clin Apher, 2019, 34(3): 171-354. PMID: 31180581. DOI: 10.1002/jca.21705.
23 中华预防医学会出生缺陷预防与控制专业委员会新生儿筛查学组, 中国医师协会医学遗传医师分会临床生化遗传专业委员会, 中国医师协会青春期医学专业委员会临床遗传学组. 葡萄糖-6-磷酸脱氢酶缺乏症新生儿筛查、诊断和治疗专家共识[J]. 中华儿科杂志, 2017, 55(6): 411-414. PMID: 28592006. DOI: 10.3760/cma.j.issn.0578-1310.2017.06.003.
24 杨雪, 谭春泽, 李聚林. 葡萄糖-6-磷酸脱氢酶缺乏症急性溶血与安全输血最新研究进展[J]. 中国实验血液学杂志, 2018, 26(5): 1569-1573. DOI: 10.7534/j.issn.1009-2137.2018.05.052.
25 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.
26 Schiffer CA, Bohlke K, Anderson KC. Platelet transfusion for patients with cancer: American Society of Clinical Oncology clinical practice guideline update summary[J]. J Oncol Pract, 2018, 14(2): 129-133. PMID: 29182492. DOI: 10.1200/JOP.2017.028902.
27 Kumar A, Mhaskar R, Grossman BJ, et al. Platelet transfusion: a systematic review of the clinical evidence[J]. Transfusion, 2015, 55(5): 1116-1127. PMID: 25387589. DOI: 10.1111/trf.12943.
28 Kaufman RM, Djulbegovic B, Gernsheimer T, et al. Platelet transfusion: a clinical practice guideline from the AABB[J]. Ann Intern Med, 2015, 162(3): 205-213. PMID: 25383671. DOI: 10.7326/M14-1589.
29 The C17Guidelines Committee. Guideline for platelet transfusion thresholds for pediatric hematology/oncology patients[M]. [2021-08-06]. https://c17.ca/application/files/6916/2006/0819/C17_Platelet_Guideline_English_Complete_2011.pdf.
30 D'Orazio JA, Neely J, Farhoudi N. ITP in children: pathophysiology and current treatment approaches[J]. J Pediatr Hematol Oncol, 2013, 35(1): 1-13. PMID: 23073045. DOI: 10.1097/MPH.0b013e318271f457.
31 Peng J, Friese P, Heilmann E, et al. Aged platelets have an impaired response to thrombin as quantitated by P-selectin expression[J]. Blood, 1994, 83(1): 161-166. PMID: 7506077.
32 Provan D, Stasi R, Newland AC, et al. International consensus report on the investigation and management of primary immune thrombocytopenia[J]. Blood, 2010, 115(2): 168-186. PMID: 19846889. DOI: 10.1182/blood-2009-06-225565.
33 中华医学会血液学分会血栓与止血学组. 成人原发免疫性血小板减少症诊断与治疗中国指南(2020年版)[J]. 中华血液学杂志, 2020, 41(8): 617-623. PMID: 32942813. PMCID: PMC7525165. DOI: 10.3760/cma.j.issn.0253-2727.2020.08.001.
34 Estcourt LJ, Birchall J, Allard S, et al. Guidelines for the use of platelet transfusions[J]. Br J Haematol, 2017, 176(3): 365-394. PMID: 28009056. DOI: 10.1111/bjh.14423.
35 Spahr JE, Rodgers GM. Treatment of immune-mediated thrombocytopenia purpura with concurrent intravenous immunoglobulin and platelet transfusion: a retrospective review of 40 patients[J]. Am J Hematol, 2008, 83(2): 122-125. PMID: 17874448. DOI: 10.1002/ajh.21060.
36 Siddiqui A, Journeycake JM, Borogovac A, et al. Recognizing and managing hereditary and acquired thrombotic thrombocytopenic purpura in infants and children[J]. Pediatr Blood Cancer, 2021, 68(5): e28949. PMID: 33660913. DOI: 10.1002/pbc.28949.
37 Lara PN, Coe TL, Zhou H, et al. Improved survival with plasma exchange in patients with thrombotic thrombocytopenic purpura-hemolytic uremic syndrome[J]. Am J Med, 1999, 107(6): 573-579. PMID: 10625026. DOI: 10.1016/s0002-9343(99)00286-7.
38 中华医学会血液学分会血栓与止血学组. 血栓性血小板减少性紫癜诊断与治疗中国指南(2022年版)[J]. 中华血液学杂志, 2022, 43(1): 7-12. PMID: 35231985. PMCID: PMC8980665. DOI: 10.3760/cma.j.issn.0253-2727.2022.01.002.
39 Coppo P, Bussel A, Charrier S, et al. High-dose plasma infusion versus plasma exchange as early treatment of thrombotic thrombocytopenic purpura/hemolytic-uremic syndrome[J]. Medicine (Baltimore), 2003, 82(1): 27-38. PMID: 12544708. DOI: 10.1097/00005792-200301000-00003.
40 Goel R, Ness PM, Takemoto CM, et al. Platelet transfusions in platelet consumptive disorders are associated with arterial thrombosis and in-hospital mortality[J]. Blood, 2015, 125(9): 1470-1476. PMID: 25588677. PMCID: PMC4342358. DOI: 10.1182/blood-2014-10-605493.
41 Srivastava A, Santagostino E, Dougall A, et al. WFH guidelines for the management of hemophilia, 3rd edition[J]. Haemophilia, 2020, 26Suppl 6: 1-158. PMID: 32744769. DOI: 10.1111/hae.14046.
PDF(592 KB)
HTML

Accesses

Citation

Detail

Sections
Recommended

/