6/30/23, 2:21 AM TRIST Pathway Feedback Search Clinical Topics Home Studies TRIST TRIST Disease Disease Disease Acute leukemia Acute myeloid leukemia Acute pro Trial question Is restrictive RBC transfusion strategy noninferior to liberal RBC transfusion strategy in patients undergoing hematopoietic cell transplantation? Study design Multi-center Open label RCT Population Characteristics of study participants 36.0% female N = 299 64.0% male 299 patients (108 female, 191 male) Inclusion criteria: patients with hematologic malignancies requiring hematopoietic cell transplantation Key exclusion criteria: pregnancy or lactation; receipt of RBC transfusion after hematopoietic cell transplantation before enrollment; or receipt of hematopoietic cell transplantation for nonmalignant diseases Interventions N=149 restrictive strategy (Hgb threshold < 70 g/L) N=150 liberal strategy (Hgb threshold < 90 g/L) https://web.pathway.md/studies/reckaRepbbQjupsg6 1/2 6/30/23, 2:21 AM TRIST Pathway Primary outcome Health-related quality of life measured by Functional Assessment of Cancer Therapy-Bone Marrow Transplantation score at day 100 112.8 112.8 107.5 84.6 56.4 Difference not exceeding nonferiority margin 28.2 0.0 Restrictive strategy Liberal strategy Difference not exceeding nonferiority margin in health-related quality of life measured by Functional Assessment of Cancer Therapy-BMT score at day 100 (112.8 vs. 107.5; AD 1.6, 95% CI -2.5 to 5.6) Secondary outcomes No significant difference in transplantation-related deaths at day 100 (1.34% vs. 2.67%; RR 0.5, 95% CI 0.09 to 2.71) No significant difference in sinusoidal obstruction syndrome (5.71% vs. 5.56%; RR 1.03, 95% CI 0.27 to 3.95) No significant difference in acute graft versus host disease (31.75% vs. 39.71%; RR 0.8, 95% CI 0.5 to 1.27) Safety outcomes No significant difference in transfusion-related adverse events. Significant difference in RBC unit transfusions (2.73 units vs. 5.02 units). Conclusion In patients with hematologic malignancies requiring hematopoietic cell transplantation, restrictive strategy was noninferior to liberal strategy with respect to a health-related quality of life measured by Functional Assessment of Cancer Therapy-BMT score at day 100. Reference Jason Tay, David S Allan, Elizabeth Chatelain et al. Liberal Versus Restrictive Red Blood Cell Transfusion Thresholds in Hematopoietic Cell Transplantation: A Randomized, Open Label, Phase III, Noninferiority Trial. J Clin Oncol. 2020 May 1;38(13):1463-1473. Open reference URL https://web.pathway.md/studies/reckaRepbbQjupsg6 2/2