Transfusion practice patterns in patients with anemia receiving myelosuppressive chemotherapy for nonmyeloid cancer: results from a prospective observational study.

Autor: Granfortuna J; Cone Health, 1200 N. Elm Street, Greensboro, NC, 27401, USA. James.Granfortuna@conehealth.com., Shoffner K; Alamance Regional Cancer Center, Cone Health, 1240 Huffman Mill Road, Burlington, NC, 27215, USA., DePasquale SE; The University of Tennessee College of Medicine, 960 East Third Street, Chattanooga, TN, 37403, USA., Badre S; Amgen Inc., One Amgen Center Drive, Thousand Oaks, CA, 91320, USA., Bohac C; Amgen Inc., One Amgen Center Drive, Thousand Oaks, CA, 91320, USA., De Oliveira Brandao C; Amgen Inc., One Amgen Center Drive, Thousand Oaks, CA, 91320, USA.
Jazyk: angličtina
Zdroj: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer [Support Care Cancer] 2018 Jun; Vol. 26 (6), pp. 2031-2038. Date of Electronic Publication: 2018 Jan 19.
DOI: 10.1007/s00520-017-4035-7
Abstrakt: Purpose: The decision to prescribe packed red blood cell (PRBC) transfusions in patients with chemotherapy-induced anemia (CIA) includes assessment of clinical features such as the patient's cancer type and treatment regimen, severity of anemia symptoms, and presence of comorbidities. We examined contemporary transfusion practices in patients with nonmyeloid cancer and CIA.
Methods: Key inclusion criteria were age ≥ 18 years with nonmyeloid cancer, receiving first/second-line myelosuppressive chemotherapy, baseline hemoglobin (Hb) ≤ 10.0 g/dL, and planned to receive ≥ 1 PRBC transfusions. Exclusion criteria were receipt of erythropoiesis-stimulating agents within 8 weeks of screening and/or chronic renal insufficiency. Data were collected from patients' medical records, laboratory values, and physician/provider questionnaires. Proportion of patients for each clinical consideration leading to a decision to prescribe a PRBC transfusion and 95% exact binomial confidence intervals were determined.
Results: The study enrolled 154 patients at 18 sites in USA; 147 (95.5%) received a PRBC transfusion. Fatigue was the most common symptom affecting the decision to prescribe a PRBC transfusion (101 [69.2%] patients). Of the three reasons selected as primary considerations for prescribing a PRBC transfusion, anemia symptoms (106 [72.1%] patients) was the most frequently reported, followed by Hb value (37 [25.2%] patients) and medical history (4 [2.7%] patients).
Conclusions: In this study, the primary consideration for prescribing a PRBC transfusion was anemia symptoms in 72.1% of patients, with only 25.2% of patients prescribed a transfusion based exclusively on Hb value. Results indicate that clinical judgment and patient symptoms, not just Hb value, were used in decisions to prescribe PRBC transfusions.
Databáze: MEDLINE
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