The use of transfusion quality indicators as a tool for hemovigilance system implementation at a tertiary care center in Saudi Arabia.

OBJECTIVES: To report 2-years experience of using transfusion-related quality indicators as a tool in hemovigilance system implementation.  METHODS: The study was carried out between 2012 and 2013. Blood transfusion service data were prospectively collected at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Donor reactions, transfusion reactions, fresh frozen plasma (FFP) in-date wastage, incidents, and errors pertaining to orders, or requests were collected quarterly and prospectively and forwarded to the Hospital Transfusion Committee (HTC) for review.  RESULTS: Donor population consisted of 23,132 donors. One hundred and forty-eight donor reactions were reported, resulting in a rate of 0.6%. Eighty-four transfusion reactions were reported and most were allergic reactions (79.7%). Errors or incidents were reported with approximately 0.3% of the total number of submitted samples/request forms. The FFP in-date wastage was 21.3% of the total FFP wastage. The HTC regularly reviewed the hemovigilance data and reporting; and safety improvements were implemented.  CONCLUSION: The use of quality indicators as a tool for developing and implementing a hemovigilance system provided a better understanding of improvement areas for continuous progress in quality and safety, and is expected to enhance these features along the blood transfusion chain.

Hydroxyurea-induced oral ulceration.

Hydroxyurea is an antimetabolite that is widely used in the treatment of many benign and malignant conditions. This drug is usually well tolerated but has a number of side effects that vary in incidence. In cases of clinically significant adverse events, hydroxyurea is usually discontinued either temporarily or permanently, depending on treatment need versus harm caused by side effects. Here, we report a case of oral ulceration associated with hydroxyurea treatment in a patient who had chronic myelogenous leukemia. The patient rapidly developed an oral ulcer 12 days after administration of the drug. Hydroxyurea was discontinued, and the oral lesion appreciably decreased in size and severity. Physicians and dentists should be aware of the association between hydroxyurea and oral lesions.