Blood transfusions in palliative medicine and symptom control in solid tumours

Area of Science:

• Palliative Care Medicine
• Hematology

Background:

• Fatigue and breathlessness are common, distressing symptoms in palliative care patients, potentially linked to anemia.
• Red cell concentrate (RCC) transfusion is frequently used, but its effectiveness in this population is not well-established.

Purpose of the Study:

• To evaluate the impact of RCC transfusion on fatigue, breathlessness, and functional status in palliative care patients.

Main Methods:

• Retrospective chart review of 33 hospice inpatients over 30 months.
• Symptom and functional scores assessed using validated tools (PCOSAS, AKPS, RUG-ADL) pre-transfusion and at 14 and 30 days post-transfusion.

Main Results:

• Fatigue improved in 58% of patients, with sustained improvement in 36% at 30 days (p=0.02).
• Limited impact on breathlessness (18% improvement) and no significant change in scores.
• Functional status declined in 36% (AKPS) and 27% (RUG-ADL), reflecting disease progression.

Conclusions:

• RCC transfusion shows potential for short-term fatigue relief in palliative care.
• Limited efficacy for breathlessness and functional status.
• High mortality and small sample size present research challenges; further prospective studies are warranted.