The International Prognostic Score and HIV status predict red cell concentrate transfusion needs in Hodgkin lymphoma

Leuk Lymphoma. 2023 Mar;64(3):613-620. doi: 10.1080/10428194.2022.2157214. Epub 2022 Dec 23.

Abstract

Despite the burden of anemia among Hodgkin lymphoma (HL) patients, data evaluating red cell concentrate transfusion are limited. We retrospectively studied 285 newly diagnosed HL patients who received first-line adriamycin, bleomycin sulfate, vinblastine sulfate, and dacarbazine (ABVD) treatment at Groote Schuur Hospital, Cape Town. HIV prevalence in the cohort was 39.5% and 74.2% of patients had advanced stage HL. Patient prognosis was scored using the HL International Prognostic Score (IPS-7) and HL IPS-3. Seventy (24.6%) patients were transfused with a median of 2 (IQR 1-5) units per patient. Compared to HIV-negative patients, more HIV-positive patients were transfused (14.1% vs. 40.4%, p < .001) and received more units, median 2 (IQR 1-3) vs. 3 (IQR 2-5), p = .035. HL IPS-7 (OR 2.1, p < .001) and HL IPS-3 (OR 2.6, p < .001) were independently associated with transfusion. HL IPS-7, HL IPS-3, and HIV positivity remained associated with transfusion after adjusting for covariates. For patients with newly diagnosed HL, HL IPS-7, HL IPS-3, and HIV status predicted transfusion.

Keywords: HIV; Hodgkin lymphoma; IPS; anemia; transfusion.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Bleomycin / therapeutic use
  • Dacarbazine / adverse effects
  • Doxorubicin / therapeutic use
  • HIV Infections* / complications
  • HIV Infections* / diagnosis
  • HIV Infections* / epidemiology
  • Hodgkin Disease* / drug therapy
  • Hodgkin Disease* / therapy
  • Humans
  • Prognosis
  • Retrospective Studies
  • South Africa
  • Vinblastine / therapeutic use

Substances

  • Bleomycin
  • Dacarbazine
  • Vinblastine
  • Doxorubicin