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

Ah Reum Lim, Jwa Hoon Kim, Myung Han Hyun, Won Jin Chang, Soohyeon Lee, Yeul Hong Kim, Kyong Hwa Park, Jong Hoon Park

    Research output: Contribution to journalArticlepeer-review

    4 Citations (Scopus)

    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.

    Original languageEnglish
    Pages (from-to)5289-5297
    Number of pages9
    JournalSupportive Care in Cancer
    Volume30
    Issue number6
    DOIs
    Publication statusPublished - 2022 Jun

    Bibliographical note

    Publisher Copyright:
    © 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

    Keywords

    • Advanced colorectal cancer
    • Cancer-related anemia
    • Minimized blood transfusion
    • Patient blood management

    ASJC Scopus subject areas

    • Oncology

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