title: Use of blood transfusion at the end of life: does it have any effects on survival of cancer patients?
abstract: BACKGROUND
  Treatment of anemia is an important issue in the palliative care setting. Blood transfusion is generally used for this purpose in supportive care. However the place of blood transfusion in terminally ill cancer cases is less far established.
  
  
  OBJECTIVE
  We aimed to outline the use of transfusions and to find the impact of blood transfusion on survival in patients with advanced cancer and very near to death.
  
  
  METHODS
  Patients dying in 2010-2011 with advanced cancer were included in the study. We retrospectively collected the data including age, type of cancer, the duration of last hospitalisation, ECOG performance status, Hb levels, transfusion history of erythrocytes and platelets, cause and the amount of transfusion. The anaemic patients who had transfusion at admission were compared with the group who were not transfused. Survival was defined as the time between the admission of last hospitalisation period and death.
  
  
  RESULTS
  Three hundred and ninety eight people with solid tumours died in 2010-2011 in our clinic. Ninety percent of the patients had anemia at the time of last hospitalisation. One hundred fifty three patients had erythrocyte transfusion at admission during the last hospitalisation period (38.4%). In the anaemic population the duration of last hospitalisation was longer in patients who had erythrocyte transfusion (15 days vs 8 days, p<0.001).
  
  
  CONCLUSIONS
  Patients who had blood transfusion at the end of life lived significantly longer than the anaemic patients who were not transfused. This study remarks that blood transfusions should not be withheld from terminal cancer patients in palliative care.
authors.affiliation: Department of Medical Oncology, Kayseri State Hospital of Research and Education, Kayseri, Turkey E-mail : semasezgingoksu@gmail.com.
authors.forename: Sema Sezgin
authors.initials: SS
authors.lastname: Goksu
authors.forename: Seyda
authors.initials: S
authors.lastname: Gunduz
authors.forename: Dilek
authors.initials: D
authors.lastname: Unal
authors.forename: Mukremin
authors.initials: M
authors.lastname: Uysal
authors.forename: Deniz
authors.initials: D
authors.lastname: Arslan
authors.forename: Ali Murat
authors.initials: AM
authors.lastname: Tatli
authors.forename: Hakan
authors.initials: H
authors.lastname: Bozcuk
authors.forename: Mustafa
authors.initials: M
authors.lastname: Ozdogan
authors.forename: Hasan Senol
authors.initials: HS
authors.lastname: Coskun
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000150:complications / Q000628:therapy*; D001803:Blood Transfusion; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008136:Longevity; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality*; D010166:Palliative Care / Q000379:methods*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D006454:Hemoglobins