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Supportive Care in Cancer

, Volume 26, Issue 6, pp 1927–1931 | Cite as

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. RoelandEmail author
Original Article

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.

Keywords

Hematologic malignancies Stem cell transplantation Blood transfusion Hospice End of life 

Notes

Funding information

This study was presented in part at the 2016 ASCO Palliative and Supportive Care in Oncology Symposium, San Francisco, CA, 2016.

Dr. Roeland’s research is supported by a UC San Diego Clinical Translational Research Institute KL2 Career Development Award (#KL2TR001444) and Cambia Health Foundation Sojourns Scholars Leadership Program.

Compliance with ethical standards

Conflict of interest

The authors declare that they no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  • Winnie S. Wang
    • 1
  • Joseph D. Ma
    • 2
  • Sandahl H. Nelson
    • 3
  • Carolyn Revta
    • 4
  • Gary T. Buckholz
    • 4
  • Carolyn Mulroney
    • 5
  • Eric J. Roeland
    • 4
    Email author
  1. 1.Internal MedicineUniversity of California (UC), San DiegoSan DiegoUSA
  2. 2.Skaggs School of Pharmacy & Pharmaceutical SciencesUC San DiegoLa JollaUSA
  3. 3.Department of Cancer Prevention and ControlUC San Diego Moores Cancer CenterLa JollaUSA
  4. 4.Division of Hematology/Oncology, Doris A. Howell Palliative Care ServiceUC San Diego Moores Cancer CenterLa JollaUSA
  5. 5.Blood and Marrow TransplantUC San Diego Moores Cancer CenterLa JollaUSA

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