Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

This Increases Acute GVHD After Allo-HSCT

Biol Blood Marrow Transplant; ePub 2018 Jan 4; Hosoba, et al

Peri-transplant red blood cell (RBC) transfusions appear to increase the risk of developing severe acute graft-vs-host disease (aGVHD) and experiencing worse overall survival following allogeneic hematopoietic stem cell transplant (allo-HSCT), according to a retrospective study involving 322 individuals. Participants with hematological malignancies received RBC transfusion before either allogeneic bone marrow or granulocyte colony-stimulating factor-mobilized blood stem cell grafts. Among the results:

  • 1 in every 5 patients developed maximal grade of III-IV aGVHD.
  • Onset occurred up to 150 days post-transplant (median onset 28 days).
  • Patients with HLA mismatch and those with a higher number of RBC units were each >twice as likely to experience grade III-IV aGVHD.
  • High-risk patients and those receiving more median RBC units were independently linked with inferior overall survival.


Hosoba S, Waller E, Shenva N, et al. Peri-transplant RBC transfusion is associated with increased risk of GvHD after allogeneic stem cell transplantation. [Published online ahead of print January 4, 2018]. Biol Blood Marrow Transplant. doi:10.1016/j.bbmt.2018.01.003.

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