Skip to main content
. Author manuscript; available in PMC: 2017 Jul 27.
Published in final edited form as: Cochrane Database Syst Rev. 2017 Jan 27;1:CD011305. doi: 10.1002/14651858.CD011305.pub2
Chantepie 2015
Trial name or title Randomized trial of two transfusion strategies in patients hospitalized for acute leukemia induction chemotherapy or hematopoietic stem cells with medico-economic evaluation (1 VERSUS 2 CGR)
Methods Open-labelled single-centre parallel-arm randomised controlled trial
Participants Inclusion criteria
18 years or older with either acute leukaemia diagnosis receiving intensive chemotherapy or autologous transplantation for lymphoma, allogeneic stem cell transplantation
Exclusion criteria
  • acute promyelocytic leukaemia

  • known ischaemic heart disease

  • acute or chronic respiratory disease

  • history of ischaemic stroke

  • disseminated intravascular coagulation

  • haemorrhagic syndrome

  • HSCT conditioning not usually associated with pRBC transfusion need such as:
    • auto-HSCTconditioned with alkeran (myeloma patients)
    • non-myelo-ablative allo-HSCT conditioned using only fludarabine and total body irradiation (TBI) 2 gray
  • erythropoietin treatment

  • autoimmune haemolytic anaemia

  • pregnancy

  • renal impairment with an estimated (modified diet in renal disease; MDRD) creatinine clearance < 50 mL/min)

  • chronic liver disease or day-1 (AST/ALT ) ≥ 2.5 upper limit of normal (ULN) (except if related to leukaemia)

  • total bilirubin ≥ 1.5 ULN

  • cirrhosis

  • age < 18 years

  • any organ failure

Interventions Two packed red blood cells Transfusion group (liberal):
Two RBC packs will be transfused to the study participants with anaemia defined as a Hb level below 80 g/L. Clinical and biological monitoring will be carried out later each day. If the Hb is < 80 g/L, two new pRBCs are transfused and so on
Single red blood packed cells Transfusion group (restrictive):
Single RBC pack will be administered in patient with anaemia defined as a Hb level below 80 g/L. Clinical and biological monitoring will be carried out later each day. If the Hb is < 80 g/L, a single unit is transfused and so on
Outcomes Primary outcome measure:
  • Number of severe complications (grade 3 or more) up to 1 month after the last day of hospitalisation , (This includes: stroke, transient ischaemic attack, acute coronary syndrome, heart failure, arrhythmias or conduction cardiac disease, deep vein thrombosis, pulmonary embolism, elevated troponin, transfer to intensive care unit, death from any cause, new or progressive radiographic infiltrates, infections related to transfusion)

Secondary outcome measures:
All will be assessed up to 1 month after the last day of hospitalisation, these will include:
  • number of RBC components transfused

  • incidence of bleeding (number of participants with bleeding grade 3 or more)

  • the number of patients with each complication defined in the primary endpoint

  • transfusion-related events (any complication declared by the physician to be related to the transfusion

  • number of days with Hb > 80 g/L

  • time to erythroid recovery

  • quality of life duration of neutropenia (from first day with neutrophils < 0.5 x 109/L to first day with neutrophils > 0.5 x 109/L)

  • transfusion performance (difference between Hb level before and 24 hours after transfusion)

  • number of RBC units transfused after leaving the unit, failure to respect the randomisation arm (number of participants who received 2 RBC units instead of single RBC unit).

Starting date Study Start Date: January 2016
Estimated Study Completion Date: January 2018
Estimated Primary Completion Date: January 2018 (Final data collection date for primary outcome measure)
Contact information DR Sylvain P Chantepie, University Hospital, Caen, France
chantepie-s@chu-caen.fr
Notes Planned recruitment: 230 adults
Sponsor: University Hospital, Caen
Trial registration: NCT02461264 on 3 June 2015
Location of trial: Caen, France
Number of study centres: 1
Tay 2011
Trial name or title Transfusion of red cells in hematopoietic stem cell transplantation (TRIST)
Methods Open-labelled multicentre parallel-arm randomised controlled trial
Participants Inclusion Criteria:
  • People aged 16 to 70 undergoing either an autologous or allogeneic HSCT for any haematological malignancy


Exclusion Criteria:
  • Pregnant or lactating at the time of enrolment

  • Already received red cell transfusion after HSCT but prior to enrolment

  • Unable/unwilling to provide informed consent

  • People receiving HSCT for any non-malignant indication

Interventions Liberal Strategy (Red cell transfusion trigger of 90 g/L):
Participants will receive 2 units of packed RBCs if the Hb level is < 90 g/L, based the day’s CBC to target a Hb level of 90 to 110 g/L
Restrictive Red cell Transfusion Strategy (Red cell transfusion trigger of 70 g/L):
Participants will receive 2 units of pRBCs if the Hb level is < 70 g/L, based on the day’s CBC to target a Hb level of 70 g/L to 90 g/L
Outcomes Primary Outcome:
Quality of Life by FACT-BMT
Secondary Outcomes:
1) Transfusion requirements (red cells, platelets and plasma), 2) Transplant-related mortality, 3) Maximum grade of GvDH, 4) Veno-occlusive disease, 5) Serious infections, 6) Bearman Toxicity Score, 7) Bleeding, 8) Quality of life by EQ 5D, FACT-Anemia, 9) Number of Hospitalisations, 10) Number of ICU admissions
Starting date March 2011
Contact information Dr Jason Tay, The Ottawa Hospital Blood and Marrow Programme, The Ottawa Hospital, Ottawa, Canada.
jtay@ottawahospital.on.ca
Notes Planned recruitment: 300 adults
Estimated study completion date: June 2016
Trial Register ID: National Institute of Health, Clinicaltrials.gov registry NCT01237639
Supported by: Canadian Blood Services (R&D Intramural Grants Competition 2010) and Canadian Institute of Health Research
Location of trial: Canada
Number of study centres: multiple

ALT = alanine transaminase

AST = aspartate transaminase

GvHD = graft versus host disease

HSCT = haematopoietic stem cell transplant

ICU = intensive care unit

pRBC(s) = packed red blood cell(s)

RBC(s) = red blood cell(s)