Blood Component Therapy in Bone Marrow Transplant Patients

Abstract

Blood fransfusions in 22 marrow transplant patients (13 allotransplants and 9 autotransplants) were studied in regards to requirement of blood components, alloimmunization, refractoriness to platelet transfusions and cytomegalovirus infections associated with granulocyte transfusions. When blood transfusions required until engraftment were compared, allotransplant patients received more red cell and platelet transfusions than autotransplant patients. This reflects delayed hematologic recovery in allotransplant patients. Further requirement of red cell or platelet transfusions was observed in 4 patients without platelet recovery compared with those with platelet recovery. Two patients developed refractoriness to platelet transfusions. Alloimmunization was confirmed in these patients who showed positive tests for lymphocytotoxic antibodies before transplantion. No relationship was observed between granulocyte transfusions and cytomegalovirus (CMV) infection or interstitial pneumonia. These observations suggest that transfusion-related alloimmunization is not so frequent in bone marrow transplant patients and most of CMV-associated interstitial pneumonia is not related to exogenous CMV infection but reactivation of endogenous CMV.