Mercadante Sebastiano, Ferrera Patrizia, Villari Patrizia, David Fabrizio, Giarratano Antonello, Riina Salvatore
Pain Relief and Palliative Care Unit, La Maddalena Cancer Center, Palermo, Italy.
J Palliat Med. 2009 Jan;12(1):60-3. doi: 10.1089/jpm.2008.0139.
The aim of this study was to assess the effects of red blood cell transfusion, and the subsequent increase in hemoglobin values, on anemia-related symptoms in a cohort of patients with cancer with different survival times. A red blood cell transfusion was recommended to a consecutive sample of patients with hemoglobin levels of 8 +/- 0.5 g/dL. The number of units to be ordered was decided according the hemoglobin values with a mean target of increasing the hemoglobin values by approximately 2 g/dL. Hemoglobin values, anemia-related signs and symptoms, including well-being, fatigue, and dyspnea, were recorded at admission (T0), 1 day after the last transfusion (T1), and 15 days afterward (T2) by telephone contact or visit. Well-being, fatigue, and dyspnea were measured on a numerical scale of 0-10. Sixty-one patients were recruited in the period of study. One hundred thirty-three units of red blood cells were transfused (mean 2.18, 95% confidence interval [CI] 0.6). Complete data were available for 40 patients. Hemoglobin values and well-being significantly increased after transfusion (T1), maintaining acceptable values 15 days afterward (T2). Significant changes in fatigue and dyspnea were found immediately after transfusion, although the effect was partially lost 15 days after transfusion. No statistical differences were found between patients with different survival times. Fatigue was significantly lower in patients with longer survival times in comparison with patients with shorter survival times (p = 0.04). Blood transfusion in patients with hemoglobin values of approximately 8 g/dL improved anemia-related symptoms on a short-term basis. This benefit is independent of the stage of disease and survival. However, the effects on dyspnea and fatigue tend to decrease within 15 days, despite the maintenance of hemoglobin values attained after transfusions, suggesting that other factors may play a role.
本研究的目的是评估红细胞输注以及随后血红蛋白值的升高对不同生存时间的癌症患者队列中贫血相关症状的影响。对于血红蛋白水平为8±0.5 g/dL的连续患者样本，建议进行红细胞输注。根据血红蛋白值确定所需输注的单位数，平均目标是使血红蛋白值增加约2 g/dL。通过电话联系或就诊，在入院时（T0）、最后一次输血后1天（T1）和之后15天（T2）记录血红蛋白值、贫血相关体征和症状，包括幸福感、疲劳和呼吸困难。幸福感、疲劳和呼吸困难采用0至10的数字量表进行测量。在研究期间招募了61名患者。共输注了133单位红细胞（平均2.18，95%置信区间[CI] 0.6）。40名患者有完整数据。输血后（T1）血红蛋白值和幸福感显著增加，15天后（T2）维持在可接受水平。输血后立即发现疲劳和呼吸困难有显著变化，尽管输血15天后效果部分消失。不同生存时间的患者之间未发现统计学差异。与生存时间较短的患者相比，生存时间较长的患者疲劳程度显著较低（p = 0.04）。血红蛋白值约为8 g/dL的患者输血在短期内改善了贫血相关症状。这种益处与疾病阶段和生存无关。然而，尽管输血后维持了血红蛋白值，但对呼吸困难和疲劳的影响在15天内趋于下降，这表明可能有其他因素起作用。
