Patients with haematologic malignancies requiring haematopoietic cell transplantation (HCT) across four Canadian HCT centres, (n=300).
Restrictive red blood cell transfusion (RBC) strategy (haemoglobin [Hb] threshold < 70 g/L), (n= 150).
Liberal RBC transfusion strategy (Hb threshold < 90 g/L), (n= 150).
After HCT, mean pre-transfusion Hb levels were 70.9 g/L in the restrictive-strategy group and 84.6 g/L in the liberal-strategy group. The number of RBC units transfused was lower in the restrictive-strategy group than in the liberal-strategy group (mean, 2.73 units vs. 5.02 units). After adjusting for transfusion type and baseline Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) score, the restrictive-strategy group had a higher FACT-BMT score at day 100 (difference of 1.6 points), which was non-inferior compared with that of the liberal-strategy group. There were no significant differences in clinical outcomes between the transfusion strategies.