Pediatric Hematologist-Oncologist Works to Standardize Premedication for Blood Product Transfusions

More judicious use of premedication does not result in increased reactions

For many children with cancer, blood product transfusions are crucial, but can be complicated by transfusion reactions. To prevent these complications, premedication is often given, although the practice is not always applied consistently and in alignment with evidence-based practice.

Melanie Degliuomini, M.D., an expert on hematologic disorders who is a board certified pediatric hematologist-oncologist at Joseph M. Sanzari Children’s Hospital at Hackensack University Medical Center, participated in a Quality Improvement initiative to standardize the practice of premedication.

The study, to be published in Pediatric Blood and Cancer, describes a significant decrease in the use of premedication (from 72% of blood product transfusions patients to 28% percent) after the implementation of standardized guidelines. Despite the decrease in premedication, the study found no increase in transfusion reactions (3.2% prior to standardization vs. 1.5% after standardization). Importantly, there were no severe transfusion reactions leading to hospitalization or death.

“Our results provide evidence in favor of more judicious use of premedication prior to transfusions in children and adolescents,” said Dr. Degliuomini. “Through this initiative, we hope to guide physicians in more consistent and evidence-based practices.”

Dr. Degliuomini treats patients with a broad range of general non-malignant blood disorders. Her research as well as clinical interests include bleeding disorders, platelet disorders, and general cytopenias (anemia, neutropenia).