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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
PubMed

Insights

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.

Keywords:
cancerclinical decisionsethicshome carepaediatricssupportive care

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