Long-term blood product transfusion support for patients with myelodysplastic syndromes (MDS): Cost analysis and complications

Pankaj Gupta, Suzanne C. Leroy, Sharon D. Luikart, Anne Bateman, Vicki A. Morrison

Research output: Contribution to journalArticlepeer-review

51 Scopus citations

Abstract

Patients with myelodysplastic syndromes (MDS) frequently become dependent on blood transfusions. We analyzed the total transfusion support required, and its complications and cost, following the diagnosis of MDS (total period = 79.7 patient-years) in 50 patients followed at the Minneapolis VA Medical Center. From diagnosis of MDS to transformation to AML or death (the MDS phase), 41 patients (82%) required transfusions. The median numbers of transfused blood products per patient per year of follow-up in the MDS phase were: packed red blood cells (pRBC), 11.1 (range, 0-91.3) units, random donor platelets (RDP), 6.8 (range, 0-581) units, and single donor apheresis platelet packs (SDP): 0 (range, 0-40) collections. In the AML phase (time from diagnosis of secondary AML to death or last follow-up), median transfusion requirements per patient (n = 5) were 24 (range, 8-88) units pRBC, 94 (range, 24-480) units RDP and 3 (range, 0-19) collections of SDP. Overall, 80% of patients required either special processing or selection of blood products, had reactions to blood products or required premedications (specified/complicated transfusions); 94% of all pRBC and 97% of all platelet transfusions were specified/complicated. The median cost of transfusions per patient was $4048 (range, $0-73 210) during the MDS phase and $13 210 (range, $5288-59 010) during the AML phase. During the MDS phase, the median cost was $4877 (range, $0-67 050) per patient-year of follow-up; the major proportion of this cost was for pRBC transfusions. Long-term support with frequent transfusions for MDS usually requires specially selected or processed blood products, and is associated with a high incidence of transfusion reactions. This study provides baseline data on the costs of transfusion support for MDS, and can be used for comparing resource utilization and costs of long- term transfusion support (supportive care) with growth factor therapy or disease-modifying modalities such as allogeneic transplantation.

Original languageEnglish (US)
Pages (from-to)953-959
Number of pages7
JournalLeukemia research
Volume23
Issue number10
DOIs
StatePublished - Oct 1999

Bibliographical note

Funding Information:
Research grant supported by the United States Department of Veterans Affairs. P Gupta provided the concept, design, contribution to the analysis and interpretation of the data, helped to draft the paper, gave critical revision and final approval to the article and provided administrative and final support. S. LeRoy contributed to the analysis and data interpretation with statistical expertise, assisted with the assembly of the data and provided logistical support. S. Luikart provided technical support, helped to draft the paper, contributed to critical revision to the paper and gave final approval. A. Bateman assisted with data collection and data interpretation and gave technical support. V. Morrison provided data, assisted with data interpretation and analysis, helped to draft the paper, provided critical revision to the article and gave final approval.

Keywords

  • Blood transfusion
  • Costs and cost analysis
  • Myelodysplastic syndromes
  • Platelet transfusion

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