BOF: Transfusion (Special Requirements)

Which of the following patients requires irradiated blood?

a) A 21 year old with Hodgkin lymphoma

b) A 26 year female with a Ewing sarcoma

c) A 3 month old baby undergoing their first red cell transfusion

d) A 3 year old with chronic mucocutaneous candidiasis

e) A 45 year old man with HIV

The answer is:

A 21 year old with Hodgkin lymphoma

Explanation:

Indications for irradiated blood products include all intrauterine transfusions (IUT) and neonatal exchange transfusions following IUTs. All immunodeficient patients should receive irradiated blood products excluding chronic mucocutaneous candidiasis HIV is not an indication for irradiated blood products.

All patients undergoing an allogeneic transplant should receive irradiated blood products from the initiation of their conditioning programme. Autograft recipients should receive irradiated products 7 days prior to stem cell harvest.

Hodgkins disease and patients receiving purine analogues are other indications. There has been debate about the indication in certain solid organ transplants such as Ewings, but these are no longer recommended indications.

Reference:

Treleaven, J., Gennery, A., Marsh, J., Norfolk, D., Page, L., Parker, A., Saran, F., Thurston, J. & Webb, D. (2011) Guidelines on the use of irradiated blood components prepared by the British Committee for Standards in Haematology blood transfusion task force. British Journal of Haematology, 152, 35–51