A randomized control trial to compare mortality in recipients of leucoreduced and non-leucoreduced whole blood transfusion in patients with cancer in Uganda

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dc.contributor.authorOkello, Clement D
dc.contributor.authorOrem, Jackson
dc.contributor.authorNabwana, Martin
dc.contributor.authorKiwanuka, Noah
dc.contributor.authorShih, Andrew W
dc.contributor.authorHeddle, Nancy
dc.contributor.authorMayanja-Kizza, Harriet
dc.date.accessioned2024-06-14T07:11:15Z
dc.date.available2024-06-14T07:11:15Z
dc.date.issued2024-05
dc.description.abstractAbstract BACKGROUNDMortality benefit of transfusion with leucoreduced whole blood has not been demonstrated in the sub-Saharan Africa (SSA). We compared mortality in patients with cancer transfused with leucoreduced and non-leucoreduced whole blood in a SSA setting.METHODSAn open-label randomized controlled trial was conducted at the Uganda Cancer Institute where participants were randomized in a 1:1 ratio into the leucoreduced and non-leucoreduced whole blood transfusion arms. Leucocyte filtration of whole blood was performed within 72 h of blood collection. Patients aged ≥ 15 years who were prescribed blood transfusion by the primary physicians were eligible for study enrolment. Mortality difference was analyzed using intention-to-treat survival analysis and cox proportional hazard model was used to analyze factors associated with mortality.RESULTSThere were 137 participants randomized to the leucoreduced and 140 to the non-leucoreduced arms. Baseline characteristics were similar between the two arms. The median number of blood transfusions received was 1 (IQR, 1-3) unit and 2 (IQR, 1-3) units in the leucoreduced and non-leucoreduced arms respectively, p = 0.07. The 30-day mortality rate in the leucoreduced arm was 4.6% (95% CI, 2.1-10) and was 6.2% (95% CI, 3.2-12.1) in the non-leucoreduced arm (p = 0.57), representing an absolute effect size of only 1.6%. Increasing age (HR = 0.92, 95% CI, 0.86-0.98, p = 0.02) and Eastern Co-operative Oncology Group (ECOG) performance score of 1 (HR = 0.03, 95% CI, 0.00-0.31, p < 0.01) were associated with reduced 30-day mortality.CONCLUSIONSThe study failed to demonstrate mortality difference between cancer patients transfused with leucoreduced and non-leucoreduced whole blood. Although this study does not support nor refute universal leucoreduction to reduce mortality in patients with cancer in SSA, it demonstrates the feasibility of doing transfusion RCTs in Uganda, where a multi-center trial with an appropriate sample size is needed.TRIAL REGISTRATIONPan African Clinical Trial Registry, https://pactr.samrc.ac.za/ (PACTR202302787440132). Registered on 06/02/2023. MEDLINE - Academicen_US
dc.identifier.citationOkello, Clement D., Jackson Orem, Martin Nabwana, et al. 'A Randomized Control Trial to Compare Mortality in Recipients of Leucoreduced and Non-Leucoreduced Whole Blood Transfusion in Patients with Cancer in Uganda', BMC Cancer, vol. 24/no. 1, (2024), pp. 677-677.en_US
dc.identifier.issnEISSN 1471-2407
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/9564
dc.language.isoenen_US
dc.publisherBioMed Centralen_US
dc.subjectMortality, Leucoreduced whole blood, Ugandaen_US
dc.titleA randomized control trial to compare mortality in recipients of leucoreduced and non-leucoreduced whole blood transfusion in patients with cancer in Ugandaen_US
dc.typeArticleen_US
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