{"title":"接受居家姑息治疗的晚期癌症患者的红细胞输注。","authors":"Rita Ostan, Silvia Varani, Ahikam David Yaaqovy, Monica Patrignani, Raffaella Pannuti, Eduardo Bruera, Guido Biasco","doi":"10.1089/jpm.2024.0153","DOIUrl":null,"url":null,"abstract":"<p><p><b><i>Background:</i></b> Red blood cell (RBC) transfusion is the standard treatment for anemia in advanced cancer. Nevertheless, guidelines for managing this condition are still not exhaustive. <b><i>Objective:</i></b> 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. <b><i>Design:</i></b> Retrospective observational study without medication. <b><i>Setting/Subjects:</i></b> Patients with advanced cancer entered in homecare during 2021 living in Bologna (Italy). <b><i>Measurements:</i></b> 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. <b><i>Results:</i></b> 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 (<i>p</i> = 0.017, <i>p</i> < 0.001, and <i>p</i> = 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 (<i>p</i> < 0.001). <b><i>Conclusion:</i></b> 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.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1639-1647"},"PeriodicalIF":2.2000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Red Blood Cell Transfusions in Patients with Advanced Cancer Receiving Home Palliative Care.\",\"authors\":\"Rita Ostan, Silvia Varani, Ahikam David Yaaqovy, Monica Patrignani, Raffaella Pannuti, Eduardo Bruera, Guido Biasco\",\"doi\":\"10.1089/jpm.2024.0153\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b><i>Background:</i></b> Red blood cell (RBC) transfusion is the standard treatment for anemia in advanced cancer. Nevertheless, guidelines for managing this condition are still not exhaustive. <b><i>Objective:</i></b> 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. <b><i>Design:</i></b> Retrospective observational study without medication. <b><i>Setting/Subjects:</i></b> Patients with advanced cancer entered in homecare during 2021 living in Bologna (Italy). <b><i>Measurements:</i></b> 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. <b><i>Results:</i></b> 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 (<i>p</i> = 0.017, <i>p</i> < 0.001, and <i>p</i> = 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 (<i>p</i> < 0.001). <b><i>Conclusion:</i></b> 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.</p>\",\"PeriodicalId\":16656,\"journal\":{\"name\":\"Journal of palliative medicine\",\"volume\":\" \",\"pages\":\"1639-1647\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2024-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of palliative medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1089/jpm.2024.0153\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/10/14 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of palliative medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1089/jpm.2024.0153","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/10/14 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
摘要
背景:输注红细胞(RBC)是治疗晚期癌症贫血的标准方法。然而,治疗这种情况的指南仍不详尽。目的:研究输注红细胞的频率、时间和临床特征:调查由居家肿瘤护理服务协助的晚期癌症患者输注红细胞的频率、时间和相关临床特征,并评估入院时的参数与居家护理期间接受红细胞输注的可能性之间的关联。设计:无药物治疗的回顾性观察研究。设置/受试者:2021 年期间在博洛尼亚(意大利)接受家庭护理的晚期癌症患者。测量在二元逻辑回归中,性别、肿瘤原发部位、肿瘤治疗和入院时的症状被视为在援助期间接受至少一次红细胞输血的可能性的可能因素。对输血数据进行分析,并追踪每位患者从入院到死亡的输血史。结果显示在收治的 1108 名患者中,有 179 人(16.2%)在家庭护理期间至少输过一次红细胞。泌尿生殖系统恶性肿瘤、血液系统恶性肿瘤以及仍在接受晚期癌症治疗的患者在护理期间接受红细胞输注的概率较高(分别为 p = 0.017、p < 0.001 和 p = 0.032)。半数患者(52%)在死亡前不到一个月接受了红细胞输注。辅助时间与最后一次输血到死亡的时间相关(p < 0.001)。结论血液和泌尿生殖系统癌症以及入院时同时接受治疗与输血有关。虽然这种治疗方法在这一人群中的适宜性仍有待确定,但输血患者经常接受 "晚期 "输血。
Red Blood Cell Transfusions in Patients with Advanced Cancer Receiving Home Palliative Care.
Background: Red blood cell (RBC) transfusion is the standard treatment for anemia in advanced cancer. Nevertheless, guidelines for managing this condition are still not exhaustive. Objective: 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. Design: Retrospective observational study without medication. Setting/Subjects: Patients with advanced cancer entered in homecare during 2021 living in Bologna (Italy). Measurements: 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. Results: 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 (p = 0.017, p < 0.001, and p = 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 (p < 0.001). Conclusion: 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.
期刊介绍:
Journal of Palliative Medicine is the premier peer-reviewed journal covering medical, psychosocial, policy, and legal issues in end-of-life care and relief of suffering for patients with intractable pain. The Journal presents essential information for professionals in hospice/palliative medicine, focusing on improving quality of life for patients and their families, and the latest developments in drug and non-drug treatments.
The companion biweekly eNewsletter, Briefings in Palliative Medicine, delivers the latest breaking news and information to keep clinicians and health care providers continuously updated.