Comparing different calculation methods of volume of packed red blood cells transfused to children with beta thalassemia attending Suez Canal University Hospital

Background Lifelong blood transfusions are often required to manage severe anemia in patients with thalassemia, a hereditary disorder of hemoglobin (Hb) synthesis. Traditional transfusion volume calculations are typically weight-based and may not be optimal, as they fail to consider other influencing factors. A novel multifactorial formula incorporating the hematocrit of transfused packed red blood cell (RBC) unit, patient weight, and both the desired and actual Hb levels has been proposed. Objective This study aimed to compare the effectiveness of the new multifactorial formula with the traditional weight-dependent method in transfusion-dependent thalassemic children, focusing on transfusion frequency, total transfused volume, and pre- and post-transfusion Hb levels over 6 months. Patients and methods A total of 40 transfusion-dependent children with beta thalassaemia (mean age 6–6.75 years) were randomly allocated into two equal groups. Group A received blood according to the traditional weight-dependent method, while Group B received transfusions calculated using the new formula. Clinical and laboratory parameters were monitored over 6 months. Results Although the total transfused packed RBCs volume did not differ significantly between groups, the novel formula (group B) resulted in a statistically significant reduction in the transfusion volume compared with the estimated volume patients would have received using the conventional method (mean 2274 vs. 2535 ml). Furthermore, 60% of patients in group B required fewer transfusions, whereas 40% of group A needed more frequent transfusions. Ferritin levels declined in 60% of patients in group B, coinciding with the reduction in transfusion frequency. The post-transfusion rise in Hb was comparable between the two groups, and no transfusion-related complications were observed. Conclusion In transfusion-dependent thalassaemia, the novel multifactorial formula significantly reduce transfusion frequency and associated iron overload, as reflected by lower ferritin levels, without sacrificing total transfused volume or total Hb targets. This approach offers a more precise, patient-centered approach to managing chronic transfusion therapy, potentially reducing complications, treatment burden, and health care costs.