Transfusion efficacy of leucoreduced packed red blood cells prepared by two different methods: A randomized controlled trial in transfusion-dependent thalassaemia patients (FUEL trial)

Background and Objectives Great variations may be observed in the haemoglobin (Hb) content of packed red blood cell (PRBC) units prepared by different methods. This study aimed to assess the Hb increment in thalassaemia major patients transfused with leucoreduced PRBCs (LPRBCs) prepared by two different methods: (i) standard leucoreduced PRBCs (SLPRBCs) and (ii) leucoreduced PRBCs prepared by a new method where leucoreduction of whole blood is done first (NLPRBCs). Materials and Methods This prospective, randomized, controlled trial included 80 adult thalassaemia major patients who were randomized into two groups of 40 each. Group I patients received SLPRBC and those of Group II received NLPRBC transfusions for 3 months. Results SLPRBCs had a mean (+/- SD) volume of 275.50 +/- 17.07 mL, while it was 316.46 +/- 1.42 mL for NLPRBCs (p < 0.001). The mean Hb content of SLPRBCs was 50.60 +/- 5.12 g, while that of NLPRBCs was 56.98 +/- 5.92 g (p < 0.001). The mean Hb increment in Group I patients was 2.11 +/- 0.89 g/dL, while that of Group II patients was 2.48 +/- 0.88 g/dL (p < 0.001). The mean transfusion interval for Group I patients was 20.30 +/- 3.75 days, while it was 21.34 +/- 5.13 days for Group II patients (p < 0.045). A significant positive correlation was observed between the Hb dose transfused and the Hb increment with both SLPRBC (rho = 0.4, p < 0.001) and NLPRBC (rho = 0.19, p = 0.011) transfusions. Conclusion NLPRBCs had significantly higher Hb content than the SLPRBCs, leading to a better Hb increment post transfusion, which may potentially prolong the transfusion interval in thalassaemia major patients.