Observational Study of Transfusion Support and Hemorrhagic Tendencies in Newly Diagnosed Patients of AML Undergoing Chemotherapy

Background: Transfusion support is an important and integral aspect for management of as substantial amount of blood may be required per patient during course of chemotherapy. We undertook this study to evaluate the quantitative aspect of blood component support in newly diagnosed AML patients undergoing chemotherapy. We also documented bleeding outcomes during the course of treatment. Methods: Newly diagnosed 19 patients who opted for chemotherapy were included in the study. Quantitative transfusion details throughout the chemotherapy were recorded. Presence of fever, bleeding, infection/sepsis and splenomegaly, use of medications such as chemotherapeutic agents, AMB, G-CSF and antifibrinolytics before every transfusion were also recorded. Results: Mean requirement of Leucopoor Red Blood Cells (LPRBC), Random Donor Platelets (RDP) and Fresh Frozen Plasma (FFP) was 14, 81.6 and 10 units respectively. Transfusion needs were more during induction as compared to consolidation phase. Bleeding was noted on 19.7 % patient days. Modified WHO grade 1 bleeding was observed on 115 days (8.8%) followed by grade 2 (6.6%) and grade 3 (4.2%). the most common site for bleeding was gastrointestinal tract (28.5%) followed by oropharynx (19.1%) patient days. No bleeding related mortality was noted. Conclusion: The study provided insights into the complex issues of transfusion requirement of AML patients. We emphasize individualizing transfusion management of these patients as clinical factors are the major determinants of transfusion requirements. We also recommend that bleeding grades should be used as an outcome measure when determining the efficacy of platelet transfusions.