TRANSFUSION REQUIREMENTS, RISKS, AND COSTS FOR PATIENTS WITH MALIGNANCY

Background: Patients with cancer often develop significant anemia, whi ch traditionally has been successfully managed by transfusion. Althoug h substantially safer than in the past, transfusions continue to carry a variety of risks. The recent licensing of erythropoietin now provid es a second treatment option, which indicates a need to reassess the u se of transfusion to manage anemia in these patients. Study Design and Methods: A 12-month retrospective chart review of all patients receiv ing outpatient transfusions at a large institution was used to identif y patients with solid tumors (including lymphoma) requiring transfusio ns for any cause. Transfusions were considered as aberrations if they necessitated unusual laboratory monitoring or resulted in clinical evi dence of a transfusion reaction. Patient charges proximately related t o the transfusion were calculated. Results: A total of 219 patients re quiring transfusions were identified, with 483 transfusion episodes an d the use of 812 units of red cells to manage anemia (mean, 3.71 units /patient). A total of 100 aberrations were recorded, Twenty-two (10%) of 219 patients had a positive antibody screen that required further w ork-up; transfusion reactions occurred in 19 patients (8.7%). Conclusi on: Careful assessment by hematologists and oncologists of the risk:be nefit ratio of erythropoietin and transfusion in patients with cancer is urged.