title: An epidemiological review of red cell transfusions in cancer chemotherapy.
abstract: OBJECTIVE
  The objective of this chart review was to determine the frequency of transfusion and prevalence of anemia (hemoglobin result < 100 g/L) in patients receiving chemotherapy.
  
  
  METHODS
  This study was a retrospective review of medical charts.
  
  
  METHODS
  Patients receiving chemotherapy were included from 12 tertiary care comprehensive cancer centres across Canada.
  
  
  METHODS
  The primary study outcome measure was red blood cell transfusion rate, controlling for patient variables.
  
  
  RESULTS
  The 616 patients included had started chemotherapy in January-June 1992. For each subject, data collection finished 4 weeks after the end of the first regimen or after a maximum follow-up period of 26 weeks. Seventy-two patients (12%; 95% confidence interval 9.5% to 14.5%) were transfused for anemia (reasons other than blood loss), and 28% (95% confidence interval 24.5% to 31.5%) of the subjects were anemic during treatment. The univariate analyses of transfusion for anemia yielded significant associations with prognostic factors. In the multivariate analyses, platinum (odds ratio [OR] = 6.69) and anthracycline (OR = 3.56) chemotherapy, baseline hemoglobin (OR = 0.96) and disease stage (OR = 1.72) were statistically significant contributors.
  
  
  CONCLUSIONS
  In this patient cohort, red blood cell transfusion was infrequent (12%). However, patient groups at high risk of transfusion could be identified, with platinum-based chemotherapy being the most significant contributing factor. The information obtained from this multicentre study may prove helpful in developing supportive care guidelines for the management of chemotherapy-related anemia requiring transfusion.
authors.affiliation: Nova Scotia Cancer Centre, Halifax.
authors.forename: J R
authors.initials: JR
authors.lastname: Skillings
authors.forename: I
authors.initials: I
authors.lastname: Rogers-Melamed
authors.forename: J M
authors.initials: JM
authors.lastname: Nabholtz
authors.forename: C
authors.initials: C
authors.lastname: Sawka
authors.forename: F
authors.initials: F
authors.lastname: Gwadry-Sridhar
authors.forename: J P
authors.initials: JP
authors.lastname: Moquin
authors.forename: M
authors.initials: M
authors.lastname: Rubinger
authors.forename: P
authors.initials: P
authors.lastname: Ganguly
authors.forename: M
authors.initials: M
authors.lastname: Burnell
authors.forename: C
authors.initials: C
authors.lastname: Shustik
authors.forename: D
authors.initials: D
authors.lastname: Dryer
authors.forename: M
authors.initials: M
authors.lastname: McLaughlin
authors.forename: D
authors.initials: D
authors.lastname: White
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000740:Anemia / Q000139:chemically induced / Q000453:epidemiology* / Q000628:therapy*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002170:Canada / Q000453:epidemiology; D015331:Cohort Studies; D017707:Erythrocyte Transfusion / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*; D016017:Odds Ratio; D015995:Prevalence; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents