BACKGROUND:
Anaemia in cancer patients can be due to the malignancy or the effects of treatment. Blood transfusions are often used to correct the anaemia and alleviate the symptoms.
Multiple studies have shown the deleterious effect of frequent transfusions in cancer patients including promoting cancer growth, transfusion related graft versus host disease, infections, immunomodulation and pulmonary decompensation. The cost of a unit of blood in Australia is around 300 dollars
AIM
We looked at the Haematology and Oncology patients in Tweed Hospital, New South Wales, who received blood transfusions from 1 October 2014 to31 May 2015.
METHODS:
This was a retrospective chart audit, with data collected from medical records, pathology reports and blood bank data. Data was analysed using Odds ratio.
RESULTS:
48 patients received transfusions from the Tweed Hospital during the period, ranging from 1 to 4 units at a time. 6 patients were transfused more than 5 times during the period. 4 patients had transfusions every two weeks, ranging from 2 to 4 units during their admission.
7 patients received transfusions within the last 6 months of their lives. 1 patient received transfusions in the last two weeks of their life.
While a haemoglobin level was available for majority of the patients prior to transfusion, many were transfused based on their symptoms only.
All patients reported symptoms of anaemia at the time of the transfusion. However, data regarding the improved quality of life was lacking.
CONCLUSIONS:
Blood transfusions are frequently used to manage anaemia in cancer patients. However use of transfusions in pre terminal patients in questionable, given that there was minimal improvement in the symptoms or quality of life. Further studies are warranted to decide regarding the cost-benefit ratio and the optimal time of cessation of transfusions in this subgroup of patients.