- Those at risk for transfusion-associated graft-versus-host disease (TA-GVHD) caused by proliferation of donor T lymphocytes
- Those who are immunocompromised
- Those receiving intrauterine transfusion
- Those with hematologic malignancies or solid tumors, including:
- Hodgkin lymphoma
- Those who are recipients of marrow or peripheral blood stem cell transplantation
- Those receiving RBCs from blood relatives or human leukocyte antigen-compatible donors
- Those receiving fludarabine therapy
- Those receiving granulocyte transfusions
According to the AABB:
- Blood components that contain viable lymphocytes may be irradiated to prevent proliferation of T lymphocytes, which is the immediate cause of TA-GVHD.
- Irradiated blood is prepared by exposing the component to a radiation source.
- The standard dose of gamma or X-ray irradiation is 2500 centigray (cGy) targeted to the central portion of the container with a minimum dose of 1500 cGy delivered to any part of the component.
- Patients at risk for TAGVHD, including:
- Fetal and neonatal recipients of intrauterine transfusions
- Selected immunocompromised recipients
- Recipients of cellular components known to be from a blood relative
- Recipients who have undergone peripheral blood progenitor cell transplantation
- Recipients of cellular components whose donor is selected for HLA compatibility and recipients of granulocyte transfusions.
- Patients receiving purine analogues (eg, fludarabine, cladribine) or certain other biological immunomodulators (eg, alemtuzumab, antithymocyte globulin) who may be at risk for TA-GVHD, depending on clinical factors and the source of the biological agent.