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Red cell transfusion benefits in oncology, haematology and palliative medicine populations: a narrative review
  1. Ed Duffy1,
  2. Frances O’Mahony2,
  3. Caroline Burke1,
  4. Aoibheann Conneely2,
  5. Helen O’Connell1 and
  6. Feargal Twomey1
  1. 1Palliative Medicine, Milford Care Centre, Castletroy, Limerick, Ireland
  2. 2Palliative Medicine, Our Lady's Hospice & Care Services, Dublin, Ireland
  1. Correspondence to Dr Ed Duffy, Palliative Medicine, Milford Care Centre, Castletroy, Limerick, Ireland; ed.duffy{at}doctors.net.uk

Abstract

Due to the heterogenous nature of the palliative medicine patient population, assessment of benefit, and thus choice of appropriate patient for consideration of transfusion, can be challenging. This can be confounded by the use of both liberal and restrictive transfusion thresholds. The multifactorial nature of many symptoms of anaemia, particularly in patients with advanced malignancy, can further complicate. As such, there is a paucity of data supporting the subjective, objective and clinical benefit of red cell transfusion in the palliative medicine setting. This narrative review summarises the research and evidence surrounding the benefits of red cell transfusion, with a particular emphasis on the oncological, haematological and palliative medicine population. There is a lack of a validated, reproducible patient-reported outcome measures (PROM) to assess response to red cell transfusions in the palliative medicine population with outcome measures varying from objective improvement in haemoglobin level post-transfusion, to subjective response in primary symptom(s). Further investigation is required regarding the development of effective PROMs assessing response to red cell transfusion in the palliative medicine population, to ensure judicious use of this scarce and valuable resource.

  • cancer
  • clinical assessment
  • drug administration
  • haematological disease
  • dyspnoea
  • fatigue

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Footnotes

  • Contributors FT, HO’C and FO’M conceived the presented idea. AC, CB and ED collected the data. ED collated the data, drafted and revised the manuscript. FT, AC and FO’M provided editorial oversight. ED is guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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