Therapeutic impact of red blood cell transfusion on anemic outpatients: the RETRO study

被引：25

作者：

St Lezin, Elizabeth ^{[1
,2
]}

Karafin, Matthew S. ^{[4
]}

Bruhn, Roberta ^{[3
]}

Chowdhury, Dhuly ^{[5
]}

Qu, Lirong ^{[6
]}

Bialkowski, Walter ^{[4
]}

Merenda, Scott ^{[8
]}

D'Andrea, Pamela ^{[7
]}

McCalla, Anne-Lyne ^{[9
]}

Anderson, Lisa ^{[4
]}

Keating, Sheila M. ^{[3
]}

Stone, Mars ^{[3
]}

Snyder, Edward L. ^{[8
]}

Brambilla, Donald ^{[5
]}

Murphy, Edward L. ^{[1
,3
]}

Norris, Philip J. ^{[1
,3
]}

Hilton, Joan F. ^{[1
]}

Spencer, Bryan R. ^{[10
]}

Kleinman, Steven ^{[11
]}

Carson, Jeffrey L. ^{[12
]}

Mast, A. E. ^{[13
]}

Gottschall, J. L. ^{[13
]}

Triulzi, D. J. ^{[14
]}

Kiss, J. E. ^{[14
]}

Murphy, E. L. ^{[15
,16
]}

St Lezin, E. M. ^{[15
,16
]}

Snyder, E. L. ^{[17
]}

Cable, R. G. ^{[18
]}

Brambilla, D. J.

Sullivan, M. T. ^{[5
]}

Busch, M. P. ^{[19
]}

Norris, P. J. ^{[19
]}

Dodd, R. Y. ^{[20
]}

Kleinman, S. H. ^{[21
]}

Glynn, S. A. ^{[22
]}

Malkin, K. B. ^{[22
]}

机构：

[1] Univ Calif San Francisco, Dept Lab Med, San Francisco, CA 94143 USA

[2] San Francisco Vet Affairs Hlth Care Syst, Dept Lab Med, San Francisco, CA USA

[3] Vitalant Res Inst, San Francisco, CA USA

[4] BloodCtr Wisconsin, MSI, Milwaukee, WI USA

[5] RTI Int, Rockville, MD USA

[6] Univ Pittsburgh, Pittsburgh, PA USA

[7] Vitalant, Pittsburgh, PA USA

[8] Yale Med Sch, New Haven, CT USA

[9] RTI Int, Res Triangle Pk, NC USA

[10] Amer Red Cross, Dedham, MA USA

[11] Univ British Columbia, Victoria, BC, Canada

[12] Rutgers Robert Wood Johnson Med Sch, New Brunswick, NJ USA

[13] BloodCtr Wisconsin BCW, Milwaukee, WI USA

[14] Inst Transfus Med ITXM, Pittsburgh, PA USA

[15] Univ Calif San Francisco, San Francisco, CA 94143 USA

[16] US Dept Vet Affairs, Med Ctr, Lab Med, San Francisco, CA USA

[17] Yale Univ, Sch Med, New Haven, CT USA

[18] Amer Red Cross Blood Serv, Farmington, CT USA

[19] Blood Syst Res Inst, San Francisco, CA USA

[20] Amer Red Cross, Holland Lab, Rockville, MD USA

[21] Univ British Columbia, Victoria, BC, Canada

[22] NHLBI, NIH, Bldg 10, Bethesda, MD 20892 USA

来源：

TRANSFUSION | 2019年 / 59卷 / 06期

关键词：

QUALITY-OF-LIFE; 6-MINUTE WALK TEST; CANCER-PATIENTS; FUNCTIONAL ASSESSMENT; ACUTE-LEUKEMIA; FATIGUE; PERFORMANCE; HEMOGLOBIN; OUTCOMES; SCALE;

D O I：

10.1111/trf.15249

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND Patients with cancer or other diagnoses associated with chronic anemia often receive red blood cell (RBC) transfusion as outpatients, but the effect of transfusion on functional status is not well demonstrated. STUDY DESIGN AND METHODS To estimate the effect of transfusion on functional status and quality of life, we measured 6-minute walk test distance and fatigue- and dyspnea-related quality-of-life scores before and 1 week after RBC transfusion in 208 outpatients age >= 50 with at least one benign or malignant hematology/oncology diagnosis. To account for potential confounding effects of cancer treatment, patients were classified into two groups based on cancer treatment within 4 weeks of the study transfusion. Minimum clinically important improvements over baseline were 20 meters in walk test distance, 3 points in fatigue score, and 2 points in dyspnea score. RESULTS The median improvement in unadjusted walk test distance was 20 meters overall and 30 meters in patients not receiving recent cancer treatment. Fatigue scores improved overall by a median of 3 points and by 4 points in patients without cancer treatment. There was no clinically important change in dyspnea scores. In multiple linear regression analysis, patients who maintained hemoglobin (Hb) levels of 8 g/dL or greater at 1 week posttransfusion, who had not received recent cancer treatment, and who did not require hospitalization during the study showed clinically important increases in mean walk test distance. CONCLUSIONS Red blood cell transfusion is associated with a modest, but clinically important improvement in walk test distance and fatigue score outcomes in adult hematology/oncology outpatients.

引用

页码：1934 / 1943

页数：10

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