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俄罗斯联邦肿瘤患者血液管理:改善肿瘤治疗的决议。

Patient blood management in oncology in the Russian Federation: Resolution to improve oncology care.

机构信息

Institute of Anesthesiology, University Hospital Zurich, Raemistrasse 100, 8032, Zurich, Switzerland; Faculty of Health and Medical Sciences, Division of Surgery, The University of Western Australia, M505 Perth, WA, 6009, Australia.

Genolier Cancer Center, Clinique de Genolier, 3 Route du Muids, CH-1272, Genolier, Switzerland.

出版信息

J Cancer Policy. 2022 Mar;31:100315. doi: 10.1016/j.jcpo.2021.100315. Epub 2021 Dec 9.

Abstract

There is accumulating evidence that anemia and iron deficiency, thrombocytopenia, blood loss and coagulopathy are independent risk factors for adverse patient outcomes in oncology and other settings. Patient blood management (PBM) aims to address these factors by managing and preserving a patient's blood. PBM improves patient health, but also reduces resource utilization, including use of allogeneic blood components, which is another risk factor for adverse outcomes. Supported by the World Health Organization and endorsed in WHA63.12, PBM is recommended by an increasing number of health authorities and is about to become a new standard of care. In support of the Russian National Long-Term Oncology Strategy 2030 to improve quality of oncological care, and with support from the National Association of Specialists in PBM, the PBM Oncology Working Group of the Russian Federation was created. In July 2020, this Group met to discuss the rationale and need for PBM in Russian oncology care. The Group recommended to include PBM as an integral part of standard oncology treatment pathways and developed a national resolution as a call to action on this matter, which was adopted in August 2020. This article details the rationale behind the resolution, delineates the action required from facilitating stakeholders (government; healthcare providers; educational facilities; research entities/institutions; funders; patient representatives/advocates), and proposes a roadmap for implementation. The generation of local health-economic and outcome data and the development of educational programs will be important in the implementation of PBM to help alleviate the health, social and economic burden of cancer.

摘要

越来越多的证据表明,贫血和缺铁、血小板减少症、失血和凝血障碍是肿瘤学和其他领域不良患者结局的独立危险因素。患者血液管理(PBM)旨在通过管理和保存患者的血液来解决这些因素。PBM 可改善患者的健康状况,还可减少资源的利用,包括异体血液成分的使用,而异体血液成分的使用也是不良结局的另一个危险因素。PBM 得到了世界卫生组织的支持,并在 WHA63.12 中得到认可,越来越多的卫生当局建议采用 PBM,并即将成为新的护理标准。为了支持俄罗斯 2030 年国家长期肿瘤学战略以改善肿瘤护理质量,并在患者血液管理专家全国协会的支持下,成立了俄罗斯联邦患者血液管理肿瘤学工作组。2020 年 7 月,该工作组召开会议,讨论了在俄罗斯肿瘤学护理中采用 PBM 的理由和必要性。该工作组建议将 PBM 作为标准肿瘤治疗方案的一个组成部分,并制定了一项国家决议,呼吁就此采取行动,该决议于 2020 年 8 月获得通过。本文详细说明了该决议背后的理由,阐述了促进利益相关者(政府;医疗保健提供者;教育机构;研究实体/机构;资助者;患者代表/倡导者)采取行动的必要性,并提出了实施该决议的路线图。生成当地卫生经济学和结果数据以及开展教育项目将是实施 PBM 的重要内容,有助于减轻癌症对健康、社会和经济的负担。

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