Cost and Indications of Blood Transfusions in Pediatric Oncology in an African Hospital

Background: Red blood cells and platelet concentrates are frequently used in paediatric oncology. There is little literature on the indications and costs of this adjuvant therapy. Aim: To retrospectively evaluate the indications, amounts and costs of transfusing blood products in 2008 in the Department of Paediatric Oncology at Tygerberg Children’s Hospital, Cape Town. Material and Method: The patient records were analyzed for age, sex, disease and stage, indications for transfusion and type of blood product as well as amount. The costs were obtained from the Blood Bank for each item released for every patient. Results: Thirty-nine children with cancer were transfused, between one unit and 34 units of blood products per patient, during their treatment in 2008. The total cost of this therapy in 2008 was ZAR 941,966 = USD 125,595 = EUR 89,711. The maximum cost per patient amounted to ZAR 70,682 = USD 9,424 = EUR 6,731 and the minimum ZAR 914 = USD 121 = EUR 87. The average expenditure per patient was ZAR 24,125 = USD 3,216 = EUR 2,297. The management of leukemia required the highest usage of blood products per patient. Conclusion: The use of blood products is indispensable during the treatment of numerous haematology – oncology diseases. Their indications should be specified in internal protocols and their actual use should be audited frequently due to the considerable costs.