AI Article Synopsis

  • Red blood cell transfusions are commonly used to treat anemia in advanced cancer patients, yet there are gaps in the management guidelines for this treatment.
  • A study conducted in Bologna, Italy, looked at the frequency and characteristics of RBC transfusions in 1,108 advanced cancer patients receiving at-home care in 2021, finding that 16.2% received at least one transfusion.
  • Results indicated that patients with genitourinary and hematological cancers, as well as those still undergoing therapy, were more likely to receive transfusions, often within a month of death, raising questions about the timing and appropriateness of this intervention.

Article Abstract

Red blood cell (RBC) transfusion is the standard treatment for anemia in advanced cancer. Nevertheless, guidelines for managing this condition are still not exhaustive. To investigate frequency, timing, and clinical characteristics associated with RBC transfusions in patients with advanced cancer assisted by at-home oncological care service and to evaluate the association between parameters at the entry and the possibility of receiving RBC transfusions during homecare. Retrospective observational study without medication. Patients with advanced cancer entered in homecare during 2021 living in Bologna (Italy). Gender, tumor primary site, oncological therapy, and symptoms at the entry were considered as possible factors in a binary logistic regression for the possibility of receiving at least one RBC transfusion during assistance. Data about transfusions were analyzed, and the transfusion history for each patient from the entry to death was traced. Among the 1108 patients admitted, 179 (16.2%) were given at least one RBC transfusion during homecare. Genitourinary, hematological malignancies, and being still in therapy for advanced cancer are associated with a higher probability of receiving RBC transfusion during assistance ( = 0.017, < 0.001, and = 0.032, respectively). Half of the patients (52%) underwent RBC transfusions less than a month before death. Duration of the assistance was correlated with the period from last transfusion to death ( < 0.001). Hematological and genitourinary cancer and being in simultaneous care at the entry were associated with transfusion. Although the appropriateness of this treatment remains to be defined in this population, transfused patients frequently received "late in life" transfusions.

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Source
http://dx.doi.org/10.1089/jpm.2024.0153DOI Listing

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