Blood transfusion has an adverse impact on the prognosis of patients receiving chemotherapy for advanced colorectal cancer: experience from a single institution with a patient blood management program
- Authors
- Lim, Ah Reum; Kim, Jwa Hoon; Hyun, Myung Han; Chang, Won-Jin; Lee, Soohyeon; Kim, Yeul Hong; Park, Kyong Hwa; Park, Jong Hoon
- Issue Date
- Jun-2022
- Publisher
- Springer Verlag
- Keywords
- Cancer-related anemia; Minimized blood transfusion; Patient blood management; Advanced colorectal cancer
- Citation
- Supportive Care in Cancer, v.30, no.6, pp 5289 - 5297
- Pages
- 9
- Indexed
- SCIE
SCOPUS
- Journal Title
- Supportive Care in Cancer
- Volume
- 30
- Number
- 6
- Start Page
- 5289
- End Page
- 5297
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/55497
- DOI
- 10.1007/s00520-022-06949-z
- ISSN
- 0941-4355
1433-7339
- Abstract
- Purpose
Perioperative blood transfusion in early stage cancer patients had a negative effect on the prognosis of patients, but the prognostic impact of transfusion in advanced cancer patients remains unclear. To minimize and guide rational transfusion, an institutional patient blood management (PBM) program was launched, and we evaluated the new program that has changed the practice and impacted on the prognosis of advanced cancer patients.
Methods
We investigated the medical records of colorectal cancer patients who received chemotherapy from 2015 to 2020. The amount and frequency of transfusion, iron replacement and laboratory findings, and overall survival were compared before and after implementation of PBM.
Results
The rate of transfusion in colorectal cancer patients was significantly decreased from 23.5/100 person-quarter in 2015 to 1.2/100 person-quarter in 2020, but iron supplementation therapy was frequently used, and the proportion of patients who received transfusion under hemoglobin 7 g/dL significantly increased from 15.9% in 2015 to 55.3% in 2020. Multivariate analysis revealed that transfusion was a significant risk factor affecting the overall survival of patients (HR 2.70, 95% CI: 1.93–3.78, p<0.001). Kaplan–Meier analysis revealed that overall survival was significantly longer in non-transfused patients than in transfused patients (11.0 versus 22.4 months; HR 0.69, 95% CI: 0.56–0.86, p<0.001).
Conclusions
This study shows that minimized transfusion through an institutional PBM can positively affect the prognosis of patients who are receiving chemotherapy for advanced colorectal cancer.
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- Appears in
Collections - 2. Clinical Science > Department of Orthopedic Surgery > 1. Journal Articles
- 2. Clinical Science > Department of Medical Oncology and Hematology > 1. Journal Articles
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