Krankenhausapotheke, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
Support Care Cancer. 2012 May;20(5):1011-21. doi: 10.1007/s00520-011-1173-1. Epub 2011 May 12.
The purpose of this study was to describe blood component (BC) use and respective cost after standard dose chemotherapy (CT) in routine hospital care.
Analysis of data from a prospective, multicenter, longitudinal, observational study on lymphoproliferative disorder (LPD) and non-small cell lung cancer (NSCLC) patients undergoing first or second line standard dose (immuno-)CT. Data were collected from patient interviews and pre-planned chart reviews. Costs of BC are presented from provider perspective.
One hundred eighty patients (n = 85 NSCLC, n = 95 LPD) receiving 189 CT lines/633 CT cycles) were evaluable (mean ± SD age, 59 ± 13.2 years, 68% stage III/IV, 14% Eastern Cooperative Oncology Group ≥ 2). During 11% of cycles, BC were transfused to 27% of patients (n = 49; n = 22 NSCLC, n = 27 LPD). Of 310 transfused units (TU), 68% were red blood cells (RBC). Mean number of TU per cycle with transfusion was 3.3 ± 2.9 (median = 2, range = 2-17) for RBC, 4.8 ± 6.8 (median = 2, range = 1-23) for platelets (PLT) and 12.8 ± 14.6 (median = 8, range = 2-33) for fresh frozen plasma (FFP). Fifteen per cent of RBC units, 60% of PLT units and 92% of FFP in this study were transfused in cycles with sepsis. Mean BC cost per CT line were euro 602 ± 1,458 (median = 135, range = 135-9,385; NSCLC: euro 292 ± 376, median = 135, range = 135-2,124; LPD: euro 1,010 ± 2,137, median = 212, range = 135-9,385, p = 0.2137). For 55% of transfused RBC units, haemoglobin levels on the day of transfusion were 8.0-8.9 g/dl, for 38% <8 g/dl and for 7% ≥ 9 g/dl. Seventy-five per cent of PLT units were transfused at a PLT count <11,000/μl and 21% at 20,000-11,000/μl.
The results reflect the diversity of BC use after standard dose CT. High transfusion need is associated with infectious complications, i.e. sepsis emphasising the need for adequate prophylaxis and further knowledge of baseline risk factors.
本研究旨在描述常规医院治疗中接受标准剂量化疗（CT）后的血液成分（BC）使用情况和相应的成本。
对接受一线或二线标准剂量（免疫）CT 的淋巴增殖性疾病（LPD）和非小细胞肺癌（NSCLC）患者进行前瞻性、多中心、纵向、观察性研究的数据进行分析。数据来自患者访谈和预先计划的图表审查。BC 成本从提供者的角度呈现。
180 名患者（n = 85 例 NSCLC，n = 95 例 LPD）接受了 189 次 CT 线/633 次 CT 周期）进行了评估（平均年龄 ± SD，59 ± 13.2 岁，68%为 III/IV 期，14%为东部合作肿瘤学组≥2）。在 11%的周期中，27%的患者（n = 49；n = 22 例 NSCLC，n = 27 例 LPD）输注了 BC。在 310 个输注单位（TU）中，68%为红细胞（RBC）。有输血的每个周期的平均 TU 数为 3.3 ± 2.9（中位数= 2，范围= 2-17）用于 RBC，4.8 ± 6.8（中位数= 2，范围= 1-23）用于血小板（PLT），12.8 ± 14.6（中位数= 8，范围= 2-33）用于新鲜冷冻血浆（FFP）。在本研究中，15%的 RBC 单位、60%的 PLT 单位和 92%的 FFP 在伴有败血症的周期中输注。每线 CT 的平均 BC 成本为 602 ± 1458 欧元（中位数= 135，范围= 135-9385；NSCLC：292 ± 376 欧元，中位数= 135，范围= 135-2124；LPD：1010 ± 2137 欧元，中位数= 212，范围= 135-9385，p = 0.2137）。对于 55%的输注 RBC 单位，输血当天的血红蛋白水平为 8.0-8.9g/dl，38%<8g/dl，7%≥9g/dl。75%的 PLT 单位在血小板计数<11000/μl 时输注，21%在 20000-11000/μl 时输注。
这些结果反映了标准剂量 CT 后 BC 使用的多样性。高输血需求与感染性并发症有关，即败血症，强调了充分预防和进一步了解基线风险因素的必要性。
