Therapeutic impact of red blood cell transfusion on anemic outpatients: the RETRO study.
Journal
Transfusion
ISSN: 1537-2995
Titre abrégé: Transfusion
Pays: United States
ID NLM: 0417360
Informations de publication
Date de publication:
06 2019
06 2019
Historique:
received:
11
12
2018
revised:
11
02
2019
accepted:
11
02
2019
pubmed:
19
3
2019
medline:
29
5
2020
entrez:
19
3
2019
Statut:
ppublish
Résumé
Patients with cancer or other diagnoses associated with chronic anemia often receive red blood cell (RBC) transfusion as outpatients, but the effect of transfusion on functional status is not well demonstrated. To estimate the effect of transfusion on functional status and quality of life, we measured 6-minute walk test distance and fatigue- and dyspnea-related quality-of-life scores before and 1 week after RBC transfusion in 208 outpatients age ≥50 with at least one benign or malignant hematology/oncology diagnosis. To account for potential confounding effects of cancer treatment, patients were classified into two groups based on cancer treatment within 4 weeks of the study transfusion. Minimum clinically important improvements over baseline were 20 meters in walk test distance, 3 points in fatigue score, and 2 points in dyspnea score. The median improvement in unadjusted walk test distance was 20 meters overall and 30 meters in patients not receiving recent cancer treatment. Fatigue scores improved overall by a median of 3 points and by 4 points in patients without cancer treatment. There was no clinically important change in dyspnea scores. In multiple linear regression analysis, patients who maintained hemoglobin (Hb) levels of 8 g/dL or greater at 1 week posttransfusion, who had not received recent cancer treatment, and who did not require hospitalization during the study showed clinically important increases in mean walk test distance. Red blood cell transfusion is associated with a modest, but clinically important improvement in walk test distance and fatigue score outcomes in adult hematology/oncology outpatients.
Sections du résumé
BACKGROUND
Patients with cancer or other diagnoses associated with chronic anemia often receive red blood cell (RBC) transfusion as outpatients, but the effect of transfusion on functional status is not well demonstrated.
STUDY DESIGN AND METHODS
To estimate the effect of transfusion on functional status and quality of life, we measured 6-minute walk test distance and fatigue- and dyspnea-related quality-of-life scores before and 1 week after RBC transfusion in 208 outpatients age ≥50 with at least one benign or malignant hematology/oncology diagnosis. To account for potential confounding effects of cancer treatment, patients were classified into two groups based on cancer treatment within 4 weeks of the study transfusion. Minimum clinically important improvements over baseline were 20 meters in walk test distance, 3 points in fatigue score, and 2 points in dyspnea score.
RESULTS
The median improvement in unadjusted walk test distance was 20 meters overall and 30 meters in patients not receiving recent cancer treatment. Fatigue scores improved overall by a median of 3 points and by 4 points in patients without cancer treatment. There was no clinically important change in dyspnea scores. In multiple linear regression analysis, patients who maintained hemoglobin (Hb) levels of 8 g/dL or greater at 1 week posttransfusion, who had not received recent cancer treatment, and who did not require hospitalization during the study showed clinically important increases in mean walk test distance.
CONCLUSIONS
Red blood cell transfusion is associated with a modest, but clinically important improvement in walk test distance and fatigue score outcomes in adult hematology/oncology outpatients.
Identifiants
pubmed: 30882919
doi: 10.1111/trf.15249
pmc: PMC6548575
mid: NIHMS1017890
doi:
Types de publication
Journal Article
Multicenter Study
Observational Study
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1934-1943Subventions
Organisme : NCATS NIH HHS
ID : UL1 TR001863
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201100005I
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201100007I
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201100002I
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN 2682011-00001l to -00009l
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201100001I
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201100009I
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201100004I
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201100008I
Pays : United States
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2019 AABB.
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