FACT-An questionnaire

Correction of Anemia and Evaluation of Efficacy of Red Blood Cell Transfusion in Patients with Oncohematological Diseases

ANEMIAS , , , , , , ,

NA Romanenko1, AV Chechetkin1, LYu Zhiguleva1, GV Grishina1, SV Bondarchuk2, SS Bessmel’tsev1

1 Russian Research Institute of Hematology and Transfusiology, 16 2-ya Sovetskaya str., Saint Petersburg, Russian Federation, 191024

2 SM Kirov Military Medical Academy, 6 Akademika Lebedeva str., Saint Petersburg, Russian Federation, 194044

For correspondence: Nikolai Aleksandrovich Romanenko, MD, PhD, 16 2-ya Sovetskaya str., Saint Petersburg, Russian Federation, 191024; Tel.: 8(812)717-58-57; Fax: 8(812)717-67-80; е-mail: rom-nik@yandex.ru

For citation: Romanenko NA, Chechetkin AV, Zhiguleva LYu, et al. Correction of Anemia and Evaluation of Efficacy of Red Blood Cell Transfusion in Patients with Oncohematological Diseases. Clinical oncohematology. 2018;11(3):265–72.

DOI: 10.21320/2500-2139-2018-11-3-265-272

ABSTRACT

Aim. To study the quality of life (QL) of patients with oncohematological diseases and anemia with respect to hemoglobin level and to evaluate the efficacy of red blood cell transfusion (RBCT).

Materials & Methods. QL of patients (n = 326) was studied using FACT-An questionnaire. RBCT efficacy was evaluated in two groups. The first group included patients (n = 28; 13 men and 15 women) with oncohematological diseases and chronic anemia aged 23–80 (median 65) years, the second (control) group included patients (n = 12; 11 men and 1 woman) after severe blood loss after injury (acute anemia) aged 25–43 (median 36) years. The baseline levels of hemoglobin (Hb) and hematocrit (Ht) were < 80 g/L and < 25 % in all patients, respectively. The target levels of Hb and Ht were > 80 g/L and > 25 %, respectively.

Results. The association between the severity of anemia and QL was shown. The lowest QL was observed in patients with grade III–IV anemia (Hb < 80 g/L). Each patient in both groups received 1–8 units of blood cells (median 2) during the hospital stay. After RBCT the levels of Hb and Ht increased from 64.1 ± 2.7 g/L to 90.2 ± 1.7 g/L and from 20.1 ± 0.8 % to 28.9 ± 0.7 %, respectively. The levels of Hb and Ht in the second (control) group increased from 65.9 ± 3.0 g/L to 88.3 ± 3.2 g/L and from 19.6 ± 0.9 % to 26.7 ± 1.4 %, respectively. Venous blood oxygen saturation (SvO2) increased in the first group from 42.0 ± 3.3 % to 57.6 ± 4.1 %, and in the second group from 51.3 ± 1.9 % to 69.0 ± 1.3 %. However, after RBCT the SvO2 level reached > 60 % only in 67.9 % of patients in the first group and in all the patients (100 %) in the second group. In 32.1 % of patients with various forms of hematologic cancer and chronic anemia tissue hypoxia was still observed after RBCT despite increased Hb > 80 g/L and Ht > 25 %. Therefore, it was proposed to raise the target Hb and Ht threshold levels for patients with low SvO2.

Conclusion. The effect of the severity of anemia on QL was demonstrated. The patients with Hb < 80 g/L were shown to have low quality of life. SvO2 determination in anemia patients proved to be of great importance for RBCT efficacy evaluation. In patients with low SvO2 (< 60 %) RBCT should be continued until the target levels of Hb 100 g/L and Ht 33 % are reached.

Keywords: anemia, chronic anemia, red blood cell transfusions, hemoglobin concentration, hematocrit, venous blood oxygen saturation, quality of life, FACT-An questionnaire.

Received: March 10, 2018

Accepted: May 30, 2018

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Malignant Lymphoproliferative Disorders with Anemia: Changes of Quality of Life in Patients Treated with Donor Red Blood Cell Transfusions and Recombinant Erythropoietin

LYMPHOID TUMORS , , , , , , , ,

S.S. Bessmeltsev1, N.A. Romanenko1, N.A. Potikhonova1, S.A. Tiranova1, M.N. Zenina1, A.E. Romanenko2, L.Yu. Zhiguleva1, K.M. Abdulkadyrov1

1 Russian Scientific Research Institute of Hematology and Transfusiology under the Federal Medico-Biological Agency, 16 2-ya Sovetskaya str., Saint Petersburg, Russian Federation, 191024

2 St. Olga Children Hospital, 2 Zemledelcheskaya str., Saint Petersburg, Russian Federation, 194156

For correspondence: Stanislav Semenovich Bessmel’tsev, DSci, Professor, 16 2-ya Sovetskaya str., Saint Petersburg, Russian Federation, 191024; Tel.: +7(812)717-58-57; e-mail: RNIIHT@mail.ru

For citation: Bessmel’tsev SS, Romanenko NA, Potikhonova NA, et al. Malignant Lymphoproliferative Disorders with Anemia: Changes of Quality of Life in Patients Treated with Donor Red Blood Cell Transfusions and Recombinant Erythropoietin. Clinical oncohematology. 2015;8(4):368–378 (In Russ).

DOI: 10.21320/2500-2139-2015-8-4-368-378

ABSTRACT

Aim. To evaluate the quality of life of anemic patients with malignant lymphoproliferative disorders after red blood cells transfusion and administration of human recombinant erythropoietin agents.

Methods. The efficacy was assessed based on evaluation of clinical data, lab test findings and quality of life (QoL) parameters using the FACT-An questionnaire. Red blood cells transfusions (RBCsT) were prescribed to anemic patients with malignant lymphoproliferative disorders (LPD) (n = 54) with initial Hb levels of 7.0 ± 0.16 g/dl. After red blood cells transfusion (Me = 3 Units) the Hb level increased up to 9.31 ± 0.12 g/dl. Human recombinant erythropoietin agents (EPO) were prescribed to LPD patients (n = 77) with initial Hb levels of 8.84 ± 0.14 g/dl.

Results. A positive response with a ³ 2.0 g/dl increase of Hb levels was observed in 52 (67.5 %) of 77 patients. The Hb level in responsive patients increased up to 12.31 ± 0.24 g/dl. Statistically significant QoL changes were observe according to «Physical well-being», «Emotional well-being», «Functional well-being», and «Anemia» scales. After EPO-therapy, significant changes were found according to «Physical well-being» and «Anemia» scales. A comparative analysis of QoL in both groups of patients demonstrated maximum changes according to the «Physical well-being» scale (from 12.9 ± 0.7 to 11.0 ± 0.8 points after RBCsT, p < 0.001; from 11.6 ± 0.7 to 9.6 ± 0.7 points on EPO, p < 0.02) and the «Anemia» scale (from 41.1 ± 2.0 to 34.2 ± 2.2 points after RBCsT, p < 0.001; from 34.5 ± 1.7 to 30.1 ± 1.6 points on EPO; p < 0.001).

Conclusion. Therefore, RBCsT and EPO therapy may significantly increase the Hb levels and improve QoL. However, the QoL of LPD patients on EPO proved to be better than that after RBCsT, because it had been possible to achieve normal and stable Hb levels.

Keywords: anemia, malignant lymphoproliferative disorders, erythropoietin, recombinant erythropoietin, donor’s red blood cells, red blood cell transfusions, quality of life, FACT-An questionnaire, «Anemia» scale.

Received: May 13, 2015

Accepted: October 12, 2015

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