Analysis of RBC Transfusion for Children with Stage Ⅳ High-risk Neuroblastoma Undergoing Autologous Hematopoietic Stem Cell Transplantation

doi:10.3969/j.issn.1671-2587.2025.03.003

JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE ›› 2025, Vol. 27 ›› Issue (3): 300-305.DOI: 10.3969/j.issn.1671-2587.2025.03.003

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Analysis of RBC Transfusion for Children with Stage Ⅳ High-risk Neuroblastoma Undergoing Autologous Hematopoietic Stem Cell Transplantation

FU Xiaoyan, ZHEN Zida, MA Shuxuan

Department of Blood Transfusion, Beijing Children's Hospital Affiliated of capital Medical University, Beijing 100045

Received:2024-11-26 Published:2025-06-23

Abstract

Abstract: Objective To evaluate the RBC transfusion demand of children with stage Ⅳ high-risk neuroblastoma undergoing autologous hematopoietic stem cell transplantation (ASCT), as well as to identify increased or prolonged RBC transfusion requirement predictors. Methods This study was a single-center retrospective clinical study, and enrolled 96 children with stage Ⅳ high-risk neuroblastoma who underwent ASCT from January 2019 to May 2024 in our hospital. Relevant clinical data were collected and analyzed, including age, gender, body surface area, hemoglobin level of graft infusion day(d₀), prophylactic transfusion conditioning regimen, CD34⁺ stem cell dose, RBC transfusion requirements during transplantation, and time to transfusion independence, etc. Results All 96 (100%) children were transfused after ASCT. From d₀ to transfusion independence, median frequency for achieving RBC was 2 (1.25, 3), median of 2 (2,3) units of RBCs was given. RBC transfusions were relatively higher in pseudohealing stage (d₄~d₆) and polar stage (d₇~d₁₄), were 46.89% and 86.46%, respectively. Median times for achieving RBC transfusion independence was 10(8, 12) days. Multivariate analysis showed that Hb≤90 g/L on d₀, RBC transfusion within 1 week before ASCT and CD34⁺ stem cell dose<4.0×10⁶/kg were associated with significantly increased RBC requirements (P<0.05). Hb≤90 g/L on d₀ and CD34⁺ stem cell dose<4.0×10⁶/kg were associated with significantly entailed longer time until RBC independence (P<0.05). Effects of age, sex, blood group and pretreatment regimen were limited or insignificant (P>0.05). Conclusion This study for the first time provided quantitative RBC transfusion data after ASCT in pediatric stage Ⅳ high-risk neuroblastoma and identified Hb≤90 g/L on d₀ and CD34⁺ stem cell dose<4.0×10⁶/kg were factors predictive of increased transfusions and prolonged transfusion independence.

Key words: Neuroblastoma, Autologous hematopoietic stem cell transplantation, Red blood cell transfusion, Prophylactic transfusion conditioning regimen

CLC Number:

R739.43R457.1

FU Xiaoyan, ZHEN Zida, MA Shuxuan. Analysis of RBC Transfusion for Children with Stage Ⅳ High-risk Neuroblastoma Undergoing Autologous Hematopoietic Stem Cell Transplantation[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2025, 27(3): 300-305.

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Analysis of RBC Transfusion for Children with Stage Ⅳ High-risk Neuroblastoma Undergoing Autologous Hematopoietic Stem Cell Transplantation

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