小児血液腫瘍性疾患に対する輸血療法

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  • Blood Transfusion Therapy for the Disease of Pediatric Hematology and Oncology

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Pediatric Transfusion Medicine Conference conducted a survey of pediatric hematologists to obtain consensus for the Guideline on Transfusion Practice announced in September 2005. Most approved of the guideline and agreed on the proposed cutoff level for hemoglobin of 7 g/dl, for a platelet count of 10, 000-20, 000 / μl, and for FFP of an INR of 2.0 or PT of 30%, and APTT of twice the standard value or below 25%. They desired additional criteria in relation to the platelet parameters, with over half of them seeking more detailed criteria in relation to the disease and pathophysiology. They also desired fresh criteria in relation to albumin and immunoglobulin levels. We need prospective randomized trials to develop criteria for granulocyte transfusions and donor lymphocyte infusion. Other options, e.g., administration of erythropoietin, G-CSF, rFVIIa and tranexamic acid, are expected to replace blood transfusion and decrease the frequency of blood transfusion. We would like to organize our pediatric community to conduct welldesigned clinical studies for the purpose of developing evidence-based guidelines for transfusion.

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