TY - JOUR
T1 - Blood transfusion has an adverse impact on the prognosis of patients receiving chemotherapy for advanced colorectal cancer
T2 - experience from a single institution with a patient blood management program
AU - Lim, Ah Reum
AU - Kim, Jwa Hoon
AU - Hyun, Myung Han
AU - Chang, Won Jin
AU - Lee, Soohyeon
AU - Kim, Yeul Hong
AU - Park, Kyong Hwa
AU - Park, Jong Hoon
N1 - Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2022/6
Y1 - 2022/6
N2 - 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.
AB - 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.
KW - Advanced colorectal cancer
KW - Cancer-related anemia
KW - Minimized blood transfusion
KW - Patient blood management
UR - http://www.scopus.com/inward/record.url?scp=85126124030&partnerID=8YFLogxK
U2 - 10.1007/s00520-022-06949-z
DO - 10.1007/s00520-022-06949-z
M3 - Article
C2 - 35277757
AN - SCOPUS:85126124030
SN - 0941-4355
VL - 30
SP - 5289
EP - 5297
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
IS - 6
ER -