Use of Blood Transfusion at the End of Life: Does it Have Any Effects on Survival of Cancer Patients?

Abstract

<b>Background:</b> Treatment of anemia is an important issue in the palliative care setting. Blood transfusion isgenerally used for this purpose in supportive care. However the place of blood transfusion in terminally ill cancercases is less far established. <br/><b>Objective</b>: We aimed to outline the use of transfusions and to find the impact ofblood transfusion on survival in patients with advanced cancer and very near to death. Design: Patients dyingin 2010-2011 with advanced cancer were included in the study. We retrospectively collected the data includingage, type of cancer, the duration of last hospitalisation, ECOG performance status, Hb levels, transfusionhistory of erythrocytes and platelets, cause and the amount of transfusion. The anaemic patients who hadtransfusion at admission were compared with the group who were not transfused. Survival was defined as thetime between the admission of last hospitalisation period and death. <br/><b>Results</b>: Three hundred and ninety eightpeople with solid tumours died in 2010-2011 in our clinic. Ninety percent of the patients had anemia at the timeof last hospitalisation. One hundred fifty three patients had erythrocyte transfusion at admission during thelast hospitalisation period (38.4%). In the anaemic population the duration of last hospitalisation was longerin patients who had erythrocyte transfusion (15 days vs 8 days, p<0.001). <br/><b>Conclusions</b>: Patients who had bloodtransfusion at the end of life lived significantly longer than the anaemic patients who were not transfused. Thisstudy remarks that blood transfusions should not be withheld from terminal cancer patients in palliative care.