Association of febrile neutropenia episodes and blood product transfusions in children with acute leukemia

Abstract

Objective

Transfusion is vital supportive therapy in leukemias, but has significant potential febrile complications. In this study, we aimed to reveal the possible effects of blood product transfusions on febrile neutropenia episodes (FNEs) in children with acute leukemia.

Methods

We obtained the relevant clinical and laboratory data from the medical records.Transfusions of red blood cell (RBC), platelet (PLT), and fresh frozen plasma (FFP) administered during FNE were recorded in detail.

Results

A total of 80 children with acute leukemia were included. A total of 235 FNE were investigated and the median age at first FNE was 4.72 years. At least one blood product transfusion was administered in 80.9 % (n = 190) of the patients with FN. The need for RBC, PLT, and total transfusions was higher in patients with AML and who were > 4 years-old. Bacteremia, gram-negative bacteria, and polymicrobial infections were more frequent in patients who received PLT transfusions. Complications were increased in patients who had ≥ 3 transfusions and had received multiple FFP and pooled PLT transfusions. Patients who received pooled PLT during previous FNE had an increased risk of death.

Conclusions

Complications were more frequent, neutrophil count was lower, durations of neutropenia and medical treatment were longer in patients who had ≥ 3 transfusions.Bacteremia, gram-negative bacteria, and polymicrobial infections were more common in children who received PLT transfusions. Therefore, patients who need multiple transfusions, especially PLT and FFP transfusions, should be closely followed up during their FNE in terms consequences of transfusion as well as severity of underlying infection.