Does packed red cell transfusion provide symptomatic benefits to cancer palliative patients?: a longitudinal study from a single private oncology center in Nepal.
Dyspnea
Fatigue
Hemoglobin
Packed red cell
Palliative care
Transfusion
Journal
BMC palliative care
ISSN: 1472-684X
Titre abrégé: BMC Palliat Care
Pays: England
ID NLM: 101088685
Informations de publication
Date de publication:
06 Aug 2019
06 Aug 2019
Historique:
received:
09
10
2018
accepted:
31
07
2019
entrez:
8
8
2019
pubmed:
8
8
2019
medline:
25
2
2020
Statut:
epublish
Résumé
Palliative patients generally present with symptoms of dyspnea, easy fatigability, lethargy and feeling of being unwell which can broadly be attributed to one root cause: cancer-related anemia. So, packed red cell transfusion is often carried out aiming to improve patients' functional status. Different cut off hemoglobin values have been suggested, with Hb < 9 g/dL the most commonly accepted. The present study aims at evaluating and comparing the benefits in subjective symptoms of fatigue and breathlessness among transfused and non-transfused palliative patients on Day 0 and Day 7. Hemoglobin values, anemia related subjective symptoms of fatigue and breathlessness were recorded from 122 patients. The patients were re-evaluated on day-7 post-transfusion. The pre and post-transfusion symptomatic benefit was compared in both transfused and non-transfused palliative care patients. The currently practiced hemoglobin trigger for packed red cell transfusion is 10 g/dL. The units of packed red cell to be transfused was decided according to the hemoglobin values targeting the rise to > 10 g/dL. A mean 1.36 units were transfused. Statistically significant improvement was observed in patient reported symptoms of fatigue and breathlessness among both transfused and non-transfused palliative patients. Anemic cancer palliative patients were found to benefit following packed red cell transfusion, suggesting a favorable association between the transfusion and patient-reported fatigue and dyspnea.
Sections du résumé
BACKGROUND
BACKGROUND
Palliative patients generally present with symptoms of dyspnea, easy fatigability, lethargy and feeling of being unwell which can broadly be attributed to one root cause: cancer-related anemia. So, packed red cell transfusion is often carried out aiming to improve patients' functional status. Different cut off hemoglobin values have been suggested, with Hb < 9 g/dL the most commonly accepted. The present study aims at evaluating and comparing the benefits in subjective symptoms of fatigue and breathlessness among transfused and non-transfused palliative patients on Day 0 and Day 7.
METHODS
METHODS
Hemoglobin values, anemia related subjective symptoms of fatigue and breathlessness were recorded from 122 patients. The patients were re-evaluated on day-7 post-transfusion. The pre and post-transfusion symptomatic benefit was compared in both transfused and non-transfused palliative care patients.
RESULTS
RESULTS
The currently practiced hemoglobin trigger for packed red cell transfusion is 10 g/dL. The units of packed red cell to be transfused was decided according to the hemoglobin values targeting the rise to > 10 g/dL. A mean 1.36 units were transfused. Statistically significant improvement was observed in patient reported symptoms of fatigue and breathlessness among both transfused and non-transfused palliative patients.
CONCLUSION
CONCLUSIONS
Anemic cancer palliative patients were found to benefit following packed red cell transfusion, suggesting a favorable association between the transfusion and patient-reported fatigue and dyspnea.
Identifiants
pubmed: 31387568
doi: 10.1186/s12904-019-0454-1
pii: 10.1186/s12904-019-0454-1
pmc: PMC6685247
doi:
Substances chimiques
Hemoglobins
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
67Références
J Clin Oncol. 2001 Jun 1;19(11):2865-74
pubmed: 11387359
Am J Med Sci. 2001 Sep;322(3):145-50
pubmed: 11570780
Oncologist. 2003;8 Suppl 1:19-21
pubmed: 12626784
Curr Hematol Rep. 2003 Mar;2(2):109-15
pubmed: 12901141
Eur J Cancer. 2004 Oct;40(15):2293-306
pubmed: 15454256
J Natl Compr Canc Netw. 2007 Nov;5(10):1054-78
pubmed: 18053429
Kathmandu Univ Med J (KUMJ). 2006 Oct-Dec;4(4):405-8
pubmed: 18603943
J Palliat Med. 2009 Jan;12(1):60-3
pubmed: 19284264
Blood Transfus. 2009 Jan;7(1):49-64
pubmed: 19290081
J Palliat Med. 2010 Nov;13(11):1327-30
pubmed: 20973677
Am Fam Physician. 2011 Mar 15;83(6):719-24
pubmed: 21404983
Future Oncol. 2011 Apr;7(4):507-17
pubmed: 21463140
Oncologist. 2011;16 Suppl 3:12-8
pubmed: 21930830
Cochrane Database Syst Rev. 2012 Feb 15;(2):CD009007
pubmed: 22336857
Cancer. 2012 Apr 15;118(8 Suppl):2261-9
pubmed: 22488700
Transfusion. 2013 Apr;53(4):696-700
pubmed: 22519756
Asian Pac J Cancer Prev. 2014;15(10):4251-4
pubmed: 24935379
Haematologica. 2015 Jan;100(1):124-32
pubmed: 25239265
CA Cancer J Clin. 2015 Mar;65(2):87-108
pubmed: 25651787
Ann Palliat Med. 2014 Jan;3(1):7-11
pubmed: 25841481
J Palliat Med. 2016 Oct;19(10):1110-1113
pubmed: 27355984
Trials. 2017 Mar 31;18(1):153
pubmed: 28359342
PLoS One. 2017 Apr 6;12(4):e0175124
pubmed: 28384214
J Palliat Med. 2017 Oct;20(10):1152-1157
pubmed: 28598239
Transfusion. 2018 Jan;58(1):233-241
pubmed: 29194669
Transfusion. 1985 May-Jun;25(3):278-9
pubmed: 4002313
Palliat Med. 1995 Oct;9(4):307-13
pubmed: 8548092
J Pain Symptom Manage. 1996 Jul;12(1):18-22
pubmed: 8718912
Semin Hematol. 1997 Jul;34(3 Suppl 2):13-9
pubmed: 9253779
N Engl J Med. 1999 Feb 11;340(6):409-17
pubmed: 9971864