Adverse transfusion reactions in patients with aplastic anaemia or myelodysplastic syndromes

Patients with aplastic anaemia or myelodysplastic syndromes frequently receive transfusions in an attempt to correct anaemia and/or thrombocytopenia, putting them at risk of adverse transfusion reactions. The aim of this study is to evaluate the incidence and the types of adverse transfusion reactions in these patients.

Adverse transfusion reaction reported in transfused patients with aplastic anaemia or myelodysplastic syndromes from all the hospitals in the Auvergne-Rhône-Alpes region of France were extracted from the national haemovigilance database system and analysed. The types of adverse transfusion reactions, their incidence, their severity, the blood component involved and its imputability were evaluated.

From 1 January 2010 to 30 June 2016, 7174 adverse transfusion reactions were reported. Seventy adverse transfusion reactions (0·9%) were reported in patients with aplastic anaemia and 193 (2·7%) in patients with myelodysplastic syndromes. Febrile non-haemolytic transfusion reaction was the most common reaction both aplastic anaemia (23 cases, 33·0%) and myelodysplastic syndrome (56 cases, 29·0%). Post-transfusion red blood cell alloimmunization was also high in both these groups (17·1% in patients with aplastic anaemia and 22·3% in patients with myelodysplastic syndrome) frequently involving anti-JK1 (Jk^a ) specificity.

Febrile non-haemolytic transfusion reaction was the most common adverse transfusion reaction in patients with aplastic anaemia or myelodysplastic syndromes who received transfusions. Post-transfusion red blood cell alloimmunization was also observed frequently, but the use of RH-KEL 1 (Rhesus-Kell)-matched red blood cell concentrates reduces this risk.