Factors Associated with Increased Red Blood Cells Transfusion Requirements in Patients with Hodgkin and Non-hodgkin Lymphoma.

BACKGROUND Anaemia is a common feature of lympho-proliferative disorders and is an important cause of poor quality of life in these patients. When indicated, packed red blood cells (PRBC) units are transfused to treat anaemia. Objective of this study was to identify risk factors associated with PRBC transfusions in lymphoma patients. METHODS This was a retrospective study done on Hodgkin lymphoma (HL) and Non-Hodgkin lymphoma (NHL) patients who had PRBC transfusions during chemotherapy. Information regarding gender, type of lymphoma, stage, baseline haemoglobin, marrow involvement and total number of PRBC units transfused was collected. RESULTS A total of 481 patients with diagnosis of HL and NHL were registered during one year period. Out of these, 108 (22.4%) had PRBC transfusions during treatment. HL and NHL patients were 30 (27.8%) and 78 (72.2%) respectively. NHL patients were older than HL (37 vs. 32 years), (p=0.03). HL patients had lower mean haemoglobin 9.3 +/- 2.56 g/dl as compared to NHL 11.33 +/- 2.42 g/dl, (p<0.05). There was significant difference in number of PRBC units transfused based on lymphoma type (NHL 6.74 +/- 5.69 vs. HL 3.97 +/- 3.0 units, p<0.05). Bone marrow involvement resulted in increased transfusion requirements (7.84 +/- 4.36 vs. 5.26 +/- 5.49 units, p<0.05) while stage of disease didn't affected significantly (I/II--4.88 +/- 4.85 and III/IV 6.30 +/- 5.33 units p=0.2). CONCLUSION A significant number of lymphoma patients need PRBC transfusions during chemotherapy. NHL patients and bone marrow involvement makes patients at higher risk for transfusions. In places, where blood bank support is not adequate, patients should be informed right from beginning to arrange donors for possible transfusions during chemotherapy.