Irradiated blood products for sickle cell patients

[tbostock]

Our hematology/oncology group orders irradiated blood products for ALL of their patients here (quite frustrating, when most of the time it is not indicated). For sickle cell patients, however, I have always understood that it is actually contraindicated due to the compromise of the red cell in the irradiation process. The idea is that their red cells are a mess, and they need red cells in the best condition possible to help with their occlusive crisis.

Any thoughts on this?

[Townsend]

Terri,

We do not routinely irradiate for our sickle cell patients. The hem/onc physicians are aware of our protocol, which were established by our Medical Director and approved by those attending physicians, as well as the Transfusion Committee physicians.

If a clinician orders blood on a patient requesting something other than our established protocols (i.e. irradiated for a sickle patient), the tech clarifies with the ordering clinician and explains our protocol. If they still insist, we would refert them to our Med Director (and honor the irradiated request temporarily if she's not immediately available).

They only time a sickle patient would receive irradiated blood is after they have been placed on a potential BMT list (currently SIB BMTs). At which point they would receive irradiated, leukoreduced, sickle negative, and CMV negative (if pt and donor test CMV neg or testing hasn't been done yet). I am not aware of any contraindication for irradiating blood for sickle patients. Any directed donation for a sickle patient would be irradiated as it would be for any other patient.

Stephanie Townsend, MT (ASCP)SBB

[Malcolm Needs ☆]

Our hematology/oncology group orders irradiated blood products for ALL of their patients here (quite frustrating, when most of the time it is not indicated). For sickle cell patients, however, I have always understood that it is actually contraindicated due to the compromise of the red cell in the irradiation process. The idea is that their red cells are a mess, and they need red cells in the best condition possible to help with their occlusive crisis.

Any thoughts on this?

I think the reason they ask for irradiated blood on all the haematology/oncology patients is because many of them are either immunocompromised or on purine analogues, in case they get unirradiated blood by mistake, because these patients are more likely to get transfusion-associated graft versus host disease than others.

:confused::confused:

[tbostock]

Here's some more info:

http://www.cbbsweb.org/enf/2001/irradsickle.html