Oncology Patients Who Develop Transfusion-Associated Circulatory Overload: An Observational Study

Area of Science:

• Oncology
• Transfusion Medicine
• Critical Care

Background:

• Transfusion-associated circulatory overload (TACO) is a significant, preventable cause of morbidity and mortality.
• Cancer patients, their treatments, and comorbidities can increase susceptibility to TACO.
• Limited literature exists on TACO specifically within the oncology population.

Purpose of the Study:

• To investigate the incidence and unique characteristics of TACO in adult cancer patients.
• To identify predisposing factors and clinical features associated with TACO in this population.

Main Methods:

• Retrospective analysis of electronic health records for 93 adult cancer patients diagnosed with TACO.
• Data collection included demographics, comorbidities, treatments, transfusion practices, and outcomes.
• Descriptive statistics were used to summarize continuous and categorical variables.

Main Results:

• TACO incidence in oncology patients was 0.84 per 1000 transfusions (6.6% of all reactions), higher than in other populations.
• Frequently observed factors included hematologic malignancy, cardiotoxic chemotherapy, pneumonia, pre-existing oxygen use, dyspnea, hypertension, renal insufficiency, and daily use of corticosteroids, diuretics, and beta-blockers.
• Elevated NT-proBNP levels were also noted in a significant proportion of patients.

Conclusions:

• Oncology patients exhibit distinct factors contributing to TACO development.
• Development of specific TACO guidelines for oncology patients, beyond current CDC criteria, is recommended.
• Implementing predictive tools for TACO can aid in early detection and management.