Background: Erythropoiesis-stimulating agents (ESAs) have been shown to reduce the need for red blood cell (RBC) transfusions and to improve quality of life for cancer patients with anaemia. However, increased risks of mortality and disease progression have been reported when using ESAs with excessive target haemoglobin levels. In 2007, the United States Food and Drug Administration and Korea Food and Drug Administration issued regulatory alerts for using ESAs in cancer patients.
Objective: This retrospective study was performed to evaluate changes in ESA prescribing patterns between 2006 and 2010 and the impact on RBC transfusions in patients with solid tumours.
Setting: The Seoul National University Hospital (SNUH) in Korea.
Methods: This study includes adult patients with solid tumours who were diagnosed and treated in the SNUH from January 2006 to December 2010. The exclusion criterion was concomitant chronic renal failure. The patients' Hb levels and prescription data for ESAs and RBC transfusions were statistically analysed. The number of inpatient and outpatient solid-tumour patients was also analysed as a baseline. Main outcome measure Prescription data on ESAs and RBC transfusion.
Results: After adjusting for the number of patient visits, the monthly mean ESA doses dispensed decreased by an average of 1,192 mcg per quarter over the last 5 years, and the number of RBC transfusions ordered increased by 3.77 instances per quarter. After correcting for the number of patients, the mean doses of ESA dispensed each month decreased by 3,190 mcg per quarter, and the number of RBC transfusions ordered increased by 9.51 instances per quarter.
Conclusion: During the last 5 years, the number of ESA doses dispensed at SNUH decreased and the number of RBC transfusions at SNUH increased, independent of the number of patients. The reduction in ESA use was thought to be due to the release of the safety alert letter in 2007. However, this study did not analyse other risk factors that may have influenced the number of RBC transfusions (e.g. metastatic cancer, comorbidities, surgery). Still, the results of this study suggest that the decreased ESA doses were relevant to the increased RBC transfusions.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s11096-012-9660-0 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Human leukocyte antigen alloimmunization in a randomized trial of amustaline/glutathione pathogen-reduced red cells in complex cardiac surgery patients.
Transfusion
January 2025
Cerus Corporation, Concord, California, USA.
Background: Although alloimmunization risk of pathogen-reduced (PR) platelets has been studied, the risk has not been reported with PR red blood cells (RBCs).
Study Design And Methods: In a Phase III, randomized, controlled trial (Red Cell Pathogen Inactivation), cardiac or thoracic-aorta surgery patients were randomized to transfusion with amustaline/glutathione PR versus conventional RBCs. Pre-transfusion and Day 28 samples were evaluated for Human leukocyte antigen (HLA) Class I and Class II antibodies at low, medium, and high cutoff values.
A New Anti-Interfering Platelet Counting Technology Utilizing Conventional Impedance and White Blood Cell Differential Channel.
Int J Lab Hematol
January 2025
Department of Laboratory Medicine, The Third Xiangya Hospital, Central South University, Changsha, People's Republic of China.
Introduction: Accurate platelet (PLT) counting is crucial for disease diagnosis and treatment, especially under the condition of thrombocytopenia and platelet transfusion. A few PLT counting approaches have been established including impedance and fluorescent methods. The impedance PLT counting (PLT-I) approach could be interfered by small non-PLT particles in the blood, such as RBC/WBC fragments, microcytes, bacteria, and cryoglobulins.
View Article and Find Full Text PDFRobotic Versus Laparoscopic Adrenalectomy for Adrenal Tumors: An Up-to-Date Meta-Analysis on Perioperative Outcomes.
Cancers (Basel)
January 2025
Department of General, Emergency Surgery and New Technologies, Baggiovara General Hospital Azienda Ospedaliero Universitaria di Modena, Via Pietro Giardini 1355, 41126 Modena, Italy.
Minimally invasive surgery (MIS) for adrenal glands is becoming increasingly developed worldwide and robotic surgery has advanced significantly. Although there are still concerns about the generalization of outcomes and the cost burden, the robotic platform shows several advantages in overcoming some laparoscopic shortcomings. A systematic review and meta-analysis were conducted using the PubMed, MEDLINE and Cochrane library databases of published articles comparing RA and LA up to January 2024.
View Article and Find Full Text PDFDissociation of IgM antibodies from red blood cells using ethylenediamine tetraacetate/glycine acid or chloroquine diphosphate.
Transfusion
January 2025
Department of Blood Transfusion, Fujita Health University Hospital, Toyoake, Japan.
Background: Ethylenediamine tetraacetate/glycine acid (EGA) and chloroquine diphosphate (CDP) are used in transfusion testing to dissociate IgG antibodies from red blood cells (RBCs). However, the ability of these reagents to dissociate IgM antibodies sensitized to RBCs has not been comprehensively elucidated. We investigated whether EGA and CDP could dissociate cold-reactive antibodies from RBCs and their effect on RBCs after dissociation treatment.
View Article and Find Full Text PDFFactors affecting the direct red cell effect on thrombosis: Hematocrit dilution and injury patterns.
J Trauma Acute Care Surg
December 2024
From the Department of Surgery, University of Cincinnati, Cincinnati, Ohio.
Background: Red blood cell (RBC) aggregation can be initiated by calcium and tissue factor, which may independently contribute to microvascular and macrovascular thrombosis after injury and transfusion. Previous studies have demonstrated that increased blood storage duration may contribute to thrombotic events. The aims of this study were to first determine the effect of blood product components, age, and hematocrit (HCT) on the aggregability of RBCs, followed by measurement of RBC aggregability in two specific injury models including traumatic brain injury (TBI) and hemorrhagic shock.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!