Consensus minimum hemoglobin level above which patients with myelodysplastic syndromes can safely forgo transfusions | Aplastic Anemia & MDS International Foundation

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

Journal Title: 
Leukemia & Lymphoma
Primary Author: 
Tanasijevic, AM
Author(s): 
Anna M Tanasijevic, Anna Revette, Heidi D Klepin, Amer Zeidan, Danielle Townsley, Courtney D DiNardo, Marie Sebert, Amy E DeZern, Richard M Stone, Emily S Magnavita, Richard Chen, Mikkael A Sekeres, Gregory A Abel
Original Publication Date: 
Wednesday, July 15, 2020

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.

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