Communication

* managing patients on fludarabine that appeared on transfusion

* Question about managing patients on fludarabine that appeared on transfusion, the mailing list of Canada's Transfusion Safety Officers

* This is the second in the "Other cases" series (cases initially published elsewhere). The original cases form only the starting point for the TraQ cases.

* This TraQ case study includes educational enhancements designed to emphasize learning points related to managing patients with special transfusion needs.

* This case'sformat is different from that of serologic cases (which investigate a specific patient's laboratory and clinical data). Instead, a transfusion-related issue is discussed in general using several different patient cases to illustrate learning points.

Case Structure

* Learning outcomes

* Original case scenario

* Background information

* Questions to be considered

* Discussion

* Summary

* Quiz

* Further Reading

Learning Outcomes

Upon completion of this exercise, participants should be able to

1. List examples of mistake-proofing tools used in transfusion medicine.

2. Explain the importance of clear policies for communicating special transfusion needs of patients to all those involved in the transfusion process.

3. Describe an example of a communication policy and procedure for patients with special transfusion needs, such as those receiving purine analogues such as fludarabine.

4. Describe regulatory standards involving patients with special transfusion needs.

Original Case Scenario

#1. Transfusion-associated GVHD after fludarabine therapy in a patient with systemic lupus erythematosus1

BACKGROUND

Fludarabine, a purine antimetabolite with potent immunosuppressive properties, has previously been associated with the development of transfusion-associated GVHD (TA-GVHD) in patients with hematologic malignancies. Its role as a risk factor for TA-GVHD in patients without underlying...