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A Retrospective Review of Blood Transfusions in Cancer Patients with Anemia

^a MCP-Hahnemann University School of Medicine, Philadelphia, Pennsylvania; ^b University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania; ^c Temple University School of Medicine, Philadelphia, Pennsylvania, USA

Correspondence: David H. Henry, M.D., Pennsylvania Oncology Hematology Associates, 700 Spruce Street, Suite 305, Philadelphia, Pennsylvania 19107, USA. Telephone: 215-829-6088; Fax: 215-829-6104; e-mail: dhhenry{at}juno.com

Background: The factors contributing to blood transfusions in patients with anemia of chronic disease are not well documented in the literature. We analyzed all blood transfusion events within a single oncology practice to determine if certain chemotherapy drugs, cancer types, or other factors necessitated more frequent transfusions.

Patients and Methods: Out of 331 patients receiving chemotherapy, 103 (31%) patients received a blood transfusion in 1995. Each of these charts was reviewed and sorted by diagnosis, treatment medications, and past transfusion and/or treatment history. Hemoglobin levels were obtained for each transfusion received in 1995.

Results: The average hemoglobin at time of transfusion was 7.9 g/dl. Higher hemoglobin levels at transfusion were observed for patients over the age of 60 and patients who received prior chemotherapy. Lower hemoglobin levels at transfusion were observed for patients receiving Epoetin Alfa and sarcoma patients. The average number of red blood cell (RBC) units transfused in 1995 was 5.1 per patient. More units were given to patients receiving etoposide, while fewer units were given to those receiving ifosfamide. We created a transfusion severity index (TSI) to jointly measure these two variables.

Conclusion: The results of this study identify transfusion needs associated with certain groups of cancer patients and with certain types of chemotherapy drugs.

Key Words. Transfusion • Anemia • Epoetin Alfa • Chemotherapy

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