Transfusion practices at end of life for hematopoietic stem cell transplant patients

Winnie S. Wang, Joseph D. Ma, Sandahl H. Nelson, Carolyn Revta, Gary T. Buckholz, Carolyn Mulroney, Eric J. Roeland

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Purpose: Limited data exist regarding transfusion practices at end of life (EOL) for hematopoietic stem cell transplant (HSCT) patients. The purpose of this study was to examine red blood cell (RBC) and platelet transfusion practices in HSCT patients who enrolled or did not enroll in hospice. Methods: This was a single-center, retrospective chart review in deceased HSCT patients. The primary objective was to determine the mean difference between the last transfusion and death in HSCT patients (n = 116) who enrolled or did not enroll in hospice. Results: Sixteen (14%) and 100 (86%) patients were enrolled in hospice and not enrolled in hospice, respectively. Hospice patients observed a larger mean difference between death and last transfusion (45.9 ± 66.7 vs. 14.6 ± 48.1 days, p < 0.0001). A higher amount of platelet, but not RBC, transfusions occurred in patients not enrolled in hospice (p = 0.04). The last transfusion that occurred more than 96 h before death was observed in 12 (75%) and 22 (22%) in hospice and non-hospice patients, respectively. For HSCT patients not enrolled in hospice, 17 patients received a transfusion on the same day of death and 31 patients received the last transfusion 24 h before death. Conclusions: Blood transfusion practices differed in HSCT patients enrolled and not enrolled in hospice. For most patients not enrolled in hospice, the last transfusion occurred 24 h before death. Future efforts should explore if limited access to blood products is a barrier to hospice enrollment for HSCT patients.

Original languageEnglish (US)
Pages (from-to)1927-1931
Number of pages5
JournalSupportive Care in Cancer
Volume26
Issue number6
DOIs
StatePublished - Jun 1 2018

Keywords

  • Blood transfusion
  • End of life
  • Hematologic malignancies
  • Hospice
  • Stem cell transplantation

ASJC Scopus subject areas

  • Oncology

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