Transfusion dependency at diagnosis and transfusion intensity during initial chemotherapy are associated with poorer outcomes in XXXX .

@entity1 @entity734 @entity1583 @entity3052
Blood transfusions can modify host immunity and clinical outcomes in @entity1583 . One thousand sixty-seven @entity1 with @entity3052 ( @entity3052 ) were studied for their transfusion dependency at initial presentation and transfusion frequency during induction chemotherapy. Three hundred five @entity1 (29  %) showed initial @entity734 to red blood cell (RBC) transfusion and 109 (10  %) to platelet transfusion. Transfusion dependency at presentation was associated with a poorer prognosis. Both initial RBC and platelet transfusion needs were associated with lower response rates (P   =   0.04 and P   =   0.03). Median overall survival (OS) was 10.8  months for @entity1 with RBC need vs 18.8  months for the other @entity1 (P   =   0.02) and 6.8  months for @entity1 with platelet transfusion need vs 13.6  months for the others (P   =   0.01). Similarly, transfusion intensity during induction therapy influenced negatively treatment outcome. Median transfusion burden per week was 2.5 (range 0-25.7) RBC units and 1.6 (range 0-15.7) platelet concentrates (PCs). Both high RBC and PC transfusion intensities were associated with lower response rates (P   =   0.003 and P   <   0.0001). Median OS was 9.08  months for @entity1 with RBC transfusions >3/week vs 18.29  months for those with RBC transfusions  <=3/week (P   =   0.0003) and 10.75  months for @entity1 with PC transfusions >2/week vs 19.96  months for those with PC  <=2/week (P   =   0.0003). RBC and platelet transfusion intensities during induction therapy remained of prognostic value in multivariate analysis. Transfusion need at presentation and the frequency of transfusions during induction chemotherapy appear as strong prognostic factors.
