Transfusion Effects in Myelodysplastic Patients: Limiting Exposure
Transfusion Effects in Myelodysplastic Patients: Limiting Exposure
The goal of this study was to compare a restrictive RBC transfusion policy (a Hb transfusion
 trigger: 7.2 gr/dl) with a more liberal RBC transfusion policy (a Hb transfusion trigger: 9.6
 gr/dl) on physical fatigue.
The goal of this study was to compare a restrictive RBC transfusion policy (a Hb transfusion
 trigger of 7.2 gr/dl) with a more liberal RBC transfusion policy (a Hb transfusion trigger of
 9.6 gr/dl) on physical fatigue.
Inclusion Criteria:

 -  diagnosis myelodysplastic syndrome (primary or secondary) based on cytopenia in at
 least 1 cell line + dysplasia in 2 cell lines (and no other cause (especially
 deficiencies)) and a pathologic anatomic diagnosis after bone marrow punction.

 -  refractory anaemia (RA): blood: ≤ 1% blasts, ≤ 1 x 109 monocytes; bone marrow: < 5%
 blasts, ringed sideroblasts ≤ 15% of the erythroid cells

 -  refractory anaemia with ringed sideroblasts (RARS): blood: ≤ 1% blasts, ≤ 1 x 109
 monocytes; bone marrow: < 5% blasts, ringed sideroblasts > 15% of the erythroid cells

 -  refractory anaemia with excess blasts (RAEB): blood: < 5% blasts, ≤ 1 x 109 monocytes;
 bone marrow: blasts ≥ 5 -≤ 20%

 -  chronic myelomonocytic leukaemia (CMML): blood: >1 x 109/l monocytes, <5% blasts; bone
 marrow: blasts < 20%, increase of the monocytic component

 -  erythrocyte transfusion need

 -  working knowledge of the national language

 -  written consent for participating this study (informed consent)

 Exclusion Criteria:

 -  candidate for bone marrow- or organ transplantation

 -  medication: growth factors (GM-CSF), or EPO

 -  patients who will receive an intensive chemotherapeutic treatment with a cytopenia,
 expected longer than 2 weeks

 -  refractory anaemia with excess blasts in transformation (RAEB-t): blood: ≥ 5% blasts
 or Auer rods; bone marrow: or blasts > 20 - < 30% or Auer rods

 -  pregnancy at the moment of inclusion

 -  patients with congenital severe haemolytic anaemia, like thalassemia or sickle cell
 anaemia

 -  patients with AIDS or a severe congenital or acquired (e.g. iatrogenic) immunological
 disorder

 -  severe active infections at the moment of inclusion

 -  severe cardiac, pulmonal, neurological, metabolic or psychiatric disease at the moment
 of inclusion