This is the largest double-blind randomized controlled trial designed to determine the utility of tylenol and diphenhydramine in reducing the incidence of allergic or febrile non-hemolytic transfusion reactions (abstract). Included patients were those admitted to a leukemia or BMT unit with no prior transfusion reaction, and all transfusions were leukoreduced. They found the incidence of reactions was 1.5/100 transfusions in the placebo group and 1.4/100 transfusions in the intervention group. Based on this (and other smaller and older trials), there is no benefit to pre-meds in cancer patients receiving leukoreduced transfusion products. As an editorialist states, it would be nice to see corroboration in a more general medical population, but for now, routine pre-med use should be discouraged (editorial)
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.