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Paediatric palliative care: why transfuse?
Guillaume Robert1,2,3, Celine Chappe4, Ana Ferreira2
1Palliative Care Centre, University Hospital, Rennes, Bretagne, France guillaume.robert@chu-rennes.fr.
BMJ Supportive & Palliative Care
|January 20, 2021
Summary
In pediatric palliative care, prioritize the child
Area of Science:
- Pediatric Oncology
- Palliative Care
- Hematology
Background:
- Palliative care for children with relapsed neuroblastoma often involves blood transfusions.
- Assessing transfusion needs typically relies on biological markers.
Observation:
- An 8-year-old boy with relapsed stage IV neuroblastoma received extensive transfusions (56 red blood cell, 31 platelet units) over 7.5 months.
- Severe exophthalmia prompted a re-evaluation of the transfusion strategy.
- The child experienced 50 hospitalizations during this period.
Findings:
- Transfusion requirements in palliative care can be substantial, comparable to curative strategies.
- The child's perspective and quality of life should be central to transfusion decisions.
Implications:
- Reassessing transfusion indications collegially and regularly is crucial.
- Further study is needed on the ethical, public health, and practical aspects of transfusion practices in pediatric palliative care.
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