Pattern of Adverse Transfusion Reactions in Acute Leukaemia Treated with Different Types of Blood Component Therapy in a Tertiary Care Hospital

Abstract

Background: Transfusion of blood products is one of the principle components of supportive management in patients with acute leukaemia. Objective: The purpose of this study was to observe the pattern of adverse transfusion reactions (ATR) in acute leukaemia patients receiving blood component therapy. Methodology: This observational study was conducted in the Department of Haematology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2018 to December 2018. Total ninety-five diagnosed case of Acute Myeloid Leukaemia (AML) and Acute Lymphoblastic Leukaemia (ALL) patients were selected for the study. Results: Four types of transfusion reactions including Febrile Non-Haemolytic Transfusion Reaction (FNHTR), Allergic, Anaphylactic, Delayed Haemolytic Transfusion Reaction (DHTR) were detected by clinical observations and relevant laboratory investigations. In this study, 25 (26.3%) patients showed different types of adverse transfusion reactions. Allergic reactions (48%) found to be the most common followed by FNHTR (32%), anaphylactic reactions (16%) and DHTR (4%). Allergic reactions (58.34%) were predominant in platelet transfusion and febrile reactions (62.5%) observed in red cell concentrate (RCC) transfusion. Urticaria, 
 pruritus, angioedema, breathlessness, stridor, shivering, hypotension were prominent symptoms in allergic and anaphylactic reactions. On the other hand, fever, chills and rigors were prominent symptoms in case of febrile non haemolytic transfusion reaction. In our study no association between transfusion reaction with age, sex, types of donor, types of platelet and unit of transfusion was found. ATRs are mostly non-severe but rarely cause severe transfusion reaction. Conclusion: For safe blood transfusion close monitoring of transfusion, early recognition of pattern of reaction and prompt action may decrease transfusion related adverse events.