Role of anti-allergic agents on attenuating transfusion reactions in adults: A systematic review and meta-analysis |
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| Authors: | Shiyuan Yu Yanxia Gao Joseph Harold Walline Xin Lu Lina Zhao Yi Li |
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| Affiliation: | 1. Emergency Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China;2. Emergency Department, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China;3. Accident and Emergency Medicine Academic Unit, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China;1. Istanbul Medical Faculty Hospital Blood Center, Istanbul University, Istanbul, Turkey;2. Istanbul Medical Faculty, Department of Medical Biology, Istanbul University, Istanbul, Turkey;3. Istanbul Medical Faculty, Department of Hematology, Istanbul University, Turkey;4. Department of Pediatric Hematology/Oncology & Bone Marrow Transplantation Unit, School of Medicine, Altunizade Hospital, Ac?badem University, Istanbul, Turkey;5. Istanbul Science University, Department of Medical Biology, Istanbul, Turkey;1. Department of Medical Oncology, Adiyaman Training and Research Hospital, Adiyaman, Turkey;2. Department of Hematology, Dicle University, Faculty of Medicine, Diyarbakir, Turkey;3. Department of Bioistatistic, Dicle University, Faculty of Medicine, Diyarbakir, Turkey;1. Department of Hematology, AIIMS, New Delhi, 110029, India;2. Haematology Day Care, AIIMS, New Delhi, 110029, India;3. Department of Transfusion Medicine and Blood Bank, AIIMS, New Delhi, 110029, India |
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| Abstract: | BackgroundAnti-allergic agents (e.g. dexamethasone, chlorpheniramine or promethazine) are commonly administered to patients prior to blood product transfusions. However, the use of these agents is largely experience-based instead of evidence-based. This meta-analysis aimed to explore the evidence behind using anti-allergic agents to attenuate transfusion reactions.Materials and MethodsThe Pubmed, EMBASE, Cochrane Library, Wanfang, Chinese National Knowledge Infrastructure (CNKI), and Chinese Biomedical literature (CMB) databases were all queried for related articles. Data from groups treated with and without anti-allergic agents were collected for meta-analysis using RevMan 5.3. Baseline characteristics and univariate statistics between groups were compared using SPSS 19.0.ResultsEight eligible articles (six case control studies and two randomized controlled trials, all with high risks of bias) were identified (22060 total cases). Administered anti-allergic agents in these studies only included dexamethasone, chlorpheniramine or promethazine. Baseline characteristics showed no significant age or gender differences between treatment or control groups. There were no significant differences between the pooled experimental or control groups (for each of the three medications) in terms of fever, pruritis, rash, airway spasm or overall transfusion reaction rates.ConclusionThere is no evidence that dexamethasone, chlorpheniramine or promethazine can prevent transfusion reactions. Avoiding the arbitrary use of such anti-allergic agents before blood transfusions may potentially avoid needless adverse drug reactions. |
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| Keywords: | Anti-allergic agents Blood transfusion Transfusion reaction Meta-analysis |
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