Transfusion Challenges in Patients with Hematological Malignancies in Sub-Saharan Africa: A Prospective Observational Study from the Uganda Cancer Institute

Sci Rep. 2020 Feb 18;10(1):2825. doi: 10.1038/s41598-020-59773-y.

Abstract

Blood transfusion is fundamental in managing hematologic malignancies. We sought to evaluate the need and availability of blood products for patients with hematological malignancies at Uganda Cancer Institute. We prospectively studied the demand and supply of blood for patients with thrombocytopenia (platelet count ≤50 × 109/L), anemia (hemoglobin ≤10 g/dL), and bleeding (WHO grade ≥2). We used Poisson generalized estimating equation regression models for longitudinal binary outcomes. Among 91 patients, the median age was 26 years (IQR, 11-47). Thrombocytopenia occurred on ≥1 day in 58% of patients and on 49% of hospital days. Platelets were transfused to 39% of patients. The mean number of platelet units requested per day was 16.2 (range 0-30); 5.1 (range 0-15) were received. Anemia occurred on ≥1 day in 90% of patients; on 78% of days; and 68% received at least one blood transfusion. The mean number of blood units requested was 36.3 (range 8-57) units per day; 14 (range 0-30) were received. Bleeding occurred on ≥1 day in 19% of patients on 8% of hospital days. Thrombocytopenia and anemia were common, but product availability was substantially below that requested. We recommend increased blood collection and adherence to strict transfusion triggers as strategies to improve blood availability.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Africa South of the Sahara / epidemiology
  • Anemia / blood
  • Anemia / epidemiology
  • Anemia / pathology
  • Blood Platelets*
  • Blood Transfusion*
  • Child
  • Female
  • Hematologic Neoplasms / blood
  • Hematologic Neoplasms / epidemiology*
  • Hematologic Neoplasms / pathology
  • Hemoglobins / metabolism
  • Hemorrhage / blood
  • Hemorrhage / epidemiology
  • Hemorrhage / pathology
  • Humans
  • Male
  • Middle Aged
  • Platelet Count
  • Platelet Transfusion*
  • Thrombocytopenia / blood
  • Thrombocytopenia / epidemiology
  • Thrombocytopenia / pathology
  • Young Adult

Substances

  • Hemoglobins