Mohammad Amouzadeh,1,*Maryam Jafari,2
1. Student research committee, Anzali International Medical Campus, Guilan University of Medical Sciences, Guilan,Iran 2. Student research committee, Anzali International Medical Campus, Guilan University of Medical Sciences, Guilan,Iran
Introduction: Anemia is a common problem in patients with cancer. The prevalence of anemia in patients with cancer varies according to clinical factors, including the type of malignancy, stage, duration of disease, and chemotherapy regimen, so the prevalence of anemia in cancer patients ranges from 30 to 90. Current guidelines recommend the active correction of anemia in cancer patients by erythropoiesis-stimulating agents (ESA) and iron supplementation. Red blood cell (RBC) transfusion is reserved for patients who are hypovolemic or patients with chronic anemia unresponsive to iron supplementation. However, there are some side effects which are PRBC transfusion promotes a systemic inflammatory response in patients and increases postoperative complications. The implementation of the patient blood management (PBM) program was suggested in 2010 to reduce RBC transfusion and maintain the quality of transfusions. The PBM program has been standardized as routine practice in the USA and most European countries, as well as in a few Asian countries. This study aims to evaluate whether the introduction of our PBM can affect the appropriateness of transfusion therapy in cancer patients.
Methods: The present review was conducted through electrical scientific databases, including Google Scholar and PubMed, by searching with keywords including oncology and blood management. After reviewing these articles, a general conclusion was extracted from all the articles.
Results: The results suggest that transfusions negatively impact cancer patient outcomes by supporting tumor growth and metastases. The number of patients receiving RBC transfusion, as well as the amount of transfused RBC, decreased after the specific guideline for cancer patients was implemented. The efficacy of transfused RBC increases from 38% to 75% in the postoperative but rises from 38% to 71% in the perioperative period of cancer patients. No difference was detected in the rate of complications, but the rate of anastomosis leakage decreased. The implementation of PBM also decreases the transfusion rate. The mean number of RBC units each patient received reduced from 1.8 to 1.3 in postoperative, and the transfusion rate was halved from 16.3% to 8.3% in postoperative.
Conclusion: According to the above, the implementation of a PBM program was associated with a decrease in the total transfusion rate and an increase in the optimal transfusion rate. It was also associated with a reduction in postoperative complications. approximately all the studies mentioned the advantage of PBM, so we can try it and if it works, we can use it to improve health.
Keywords: Patient blood management
PBM
Cancer
Anemia