Faculty Collaboration Database

Therapeutic impact of red blood cell transfusion on anemic outpatients: the RETRO study. Transfusion 2019 Jun;59(6):1934-1943

Date

03/19/2019

Pubmed ID

30882919

Pubmed Central ID

PMC6548575

DOI

10.1111/trf.15249

Scopus ID

2-s2.0-85066857430 (requires institutional sign-in at Scopus site)   24 Citations

Abstract

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.

Author List

St Lezin E, Karafin MS, Bruhn R, Chowdhury D, Qu L, Bialkowski W, Merenda S, D'Andrea P, McCalla AL, Anderson L, Keating SM, Stone M, Snyder EL, Brambilla D, Murphy EL, Norris PJ, Hilton JF, Spencer BR, Kleinman S, Carson JL, NHLBI Recipient Epidemiology and Donor Evaluation Study (REDS)-III Program

Author

Walter Biakowski in the CTSI department at Medical College of Wisconsin - CTSI

MESH terms used to index this publication - Major topics in bold

Aged
Ambulatory Care
Anemia
Dyspnea
Erythrocyte Transfusion
Exercise Test
Fatigue
Female
Hospitalization
Humans
Male
Middle Aged
Prospective Studies
Quality of Life
Treatment Outcome