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Open Access 01-11-2024 | Pediatric Cancer | Review

Prophylactic red blood cell transfusions in children and neonates with cancer: An evidence-based clinical practice guideline

Authors: Demi M. Kruimer, Debbie C. Stavleu, Renée L. Mulder, Leontien C. M. Kremer, Wim J. E. Tissing, Erik A. H. Loeffen, On behalf of the prophylactic red blood cell transfusion guideline panel

Published in: Supportive Care in Cancer | Issue 11/2024

Abstract

Background

Red blood cell (RBC) transfusions play an important role in supportive care in children and neonates with cancer. However, in current clinical practice, evidence-based recommendations are lacking on when to administer prophylactic RBC transfusions. To address this gap, a clinical practice guideline (CPG) was developed to systematically review the available evidence and provide recommendations for clinicians.

Methods

A systematic literature review in three databases was conducted. The GRADE methodology was used to assess, extract, and summarize the evidence. A multidisciplinary panel of 21 professionals was assembled to ensure comprehensive expertise. If there was insufficient evidence in children with cancer, additional evidence was gathered in general pediatric or adult oncology guidelines, or the panel utilized shared expert opinion to develop a comprehensive CPG. Multiple in-person meetings were conducted to discuss evidence, complete evidence-to-decision frameworks, and formulate recommendations.

Results

Four studies including 203 children with all types of cancer, met the inclusion criteria. The expert panel assessed all evidence and translated it into recommendations. In total, 47 recommendations were formulated regarding RBC transfusions in children and neonates with cancer. For instance, specific thresholds for prophylactic RBC transfusions were recommended for children and neonates with cancer who have sepsis, are on ECMO, or are undergoing radiotherapy.

Conclusion

This clinical practice guideline presents evidence-based recommendations regarding RBC transfusions in children and neonates with cancer. By providing these recommendations, we aim to guide clinicians and contribute to improving outcomes for children and neonates with cancer.

Available only for authorised users

Important note: The content of this guideline includes expert opinions and recommendations related to blood transfusions. It is crucial to understand that these expert opinions are guiding principles and are intended to serve as a reference for medical decision-making. They do not constitute legally binding regulations and are not meant to compel medical professionals to deviate from their professional judgment in any way. Medical professionals retain the right to, in accordance with their professional assessment, deviate from the recommendations outlined herein. The use of this guideline in legal proceedings should be approached with caution, as it serves as a guide for medical practice and does not impose absolute standards. Always consult your own legal counsel or medical professionals for specific legal or medical issues.

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Title: Prophylactic red blood cell transfusions in children and neonates with cancer: An evidence-based clinical practice guideline
Authors: Demi M. Kruimer
Debbie C. Stavleu
Renée L. Mulder
Leontien C. M. Kremer
Wim J. E. Tissing
Erik A. H. Loeffen
On behalf of the prophylactic red blood cell transfusion guideline panel
Publication date: 01-11-2024
Publisher: Springer Berlin Heidelberg
Keywords: Pediatric Cancer
Transfusion Medicine
Septicemia
Pediatric Hematology and Oncology
Published in: Supportive Care in Cancer / Issue 11/2024
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-024-08888-3

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Prophylactic red blood cell transfusions in children and neonates with cancer: An evidence-based clinical practice guideline

Abstract

Background

Methods

Results

Conclusion

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