Consensus minimum hemoglobin level above which patients with myelodysplastic syndromes can safely forgo transfusions

Leuk Lymphoma. 2020 Dec;61(12):2900-2904. doi: 10.1080/10428194.2020.1791854. Epub 2020 Jul 15.

Abstract

The anemia of MDS often results in decreased quality of life, which is invoked to justify red cell transfusions; however, there are sparse data regarding the minimum hemoglobin (Hb) at which it is safe to forgo transfusions for patients with no evidence of end-organ damage. This issue is even more important in the COVID-19 era, where decreases in blood donations have stressed the blood supply. In March 2018, using a modified Delphi method, we convened a panel of 13 expert MDS clinicians for three iterative rounds to discuss a minimum safe Hb for this population. While the panel was unable to reach the pre-set consensus of 75% for a specific Hb threshold, there was 100% consensus that it be no greater than 7.5 g/dL. Our data suggest that, given no end-organ effects of anemia, patients with MDS can safely forgo transfusions with a Hb of 7.5 g/dL or higher.

Keywords: Myelodysplastic syndromes; hemoglobin threshold; transfusion.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anemia / diagnosis
  • Anemia / etiology
  • Anemia / therapy*
  • Blood Donors
  • Blood Transfusion / standards*
  • COVID-19 / epidemiology
  • COVID-19 / prevention & control
  • COVID-19 / transmission
  • Clinical Decision-Making
  • Communicable Disease Control / standards
  • Consensus
  • Delphi Technique
  • Hematology / standards
  • Hemoglobins / analysis*
  • Hemoglobins / standards
  • Humans
  • Myelodysplastic Syndromes / blood
  • Myelodysplastic Syndromes / complications
  • Myelodysplastic Syndromes / therapy*
  • Pandemics / prevention & control
  • Practice Guidelines as Topic / standards*
  • Reference Values
  • SARS-CoV-2 / pathogenicity
  • Tissue and Organ Harvesting / standards

Substances

  • Hemoglobins