{"title":"Effectiveness and Safety of Home-Based RBC Transfusions in Advanced Hematologic and Solid Tumors.","authors":"Naohiro Miyashita, Kota Ohashi, Masahiro Onozawa","doi":"10.1016/j.jpainsymman.2025.09.021","DOIUrl":null,"url":null,"abstract":"<p><strong>Context: </strong>Home-based red blood cell transfusion (RBC-TF) offers a potential treatment for terminally ill patients who suffer from anemia-related symptoms but face difficulties visiting medical facilities. However, its clinical utility and safety remain underexplored.</p><p><strong>Objectives: </strong>To evaluate the effectiveness, safety, and procedural characteristics of home-based RBC-TF in terminally ill patients with hematological malignancies (HM) and solid tumors (ST).</p><p><strong>Methods: </strong>This retrospective study included patients with terminal-stage HM or ST who received home-based RBC-TF between July 2020 and February 2025. Symptom relief was used to assess effectiveness, and adverse events (AEs) were documented to evaluate safety. Biomarkers related to cancer cachexia were also analyzed. All transfusions followed standardized protocols, including premedication and the use of leukoreduced and irradiated RBCs.</p><p><strong>Results: </strong>Seventy-seven patients (58 HM, 19 ST) received 1,664 units of RBCs. Symptom improvement was significantly greater in HM patients compared to ST patients for fatigue (94.1% vs. 53.8%, P = 0.003) and appetite loss (55.0% vs. 6.7%, P = 0.004). No severe AEs were observed; two mild allergic reactions occurred (0.29%). ST patients exhibited more severe cachexia-related markers, including lower albumin and higher CRP levels.</p><p><strong>Conclusion: </strong>Home-based RBC-TF is a feasible and safe palliative intervention for carefully selected patients, especially those with HM. Standardized transfusion protocols may contribute to improved safety. Patient selection is essential, particularly in those with advanced cachexia who may experience limited benefit.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":3.5000,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of pain and symptom management","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jpainsymman.2025.09.021","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Context: Home-based red blood cell transfusion (RBC-TF) offers a potential treatment for terminally ill patients who suffer from anemia-related symptoms but face difficulties visiting medical facilities. However, its clinical utility and safety remain underexplored.
Objectives: To evaluate the effectiveness, safety, and procedural characteristics of home-based RBC-TF in terminally ill patients with hematological malignancies (HM) and solid tumors (ST).
Methods: This retrospective study included patients with terminal-stage HM or ST who received home-based RBC-TF between July 2020 and February 2025. Symptom relief was used to assess effectiveness, and adverse events (AEs) were documented to evaluate safety. Biomarkers related to cancer cachexia were also analyzed. All transfusions followed standardized protocols, including premedication and the use of leukoreduced and irradiated RBCs.
Results: Seventy-seven patients (58 HM, 19 ST) received 1,664 units of RBCs. Symptom improvement was significantly greater in HM patients compared to ST patients for fatigue (94.1% vs. 53.8%, P = 0.003) and appetite loss (55.0% vs. 6.7%, P = 0.004). No severe AEs were observed; two mild allergic reactions occurred (0.29%). ST patients exhibited more severe cachexia-related markers, including lower albumin and higher CRP levels.
Conclusion: Home-based RBC-TF is a feasible and safe palliative intervention for carefully selected patients, especially those with HM. Standardized transfusion protocols may contribute to improved safety. Patient selection is essential, particularly in those with advanced cachexia who may experience limited benefit.
背景：家庭红细胞输注（RBC-TF）为患有贫血相关症状但就诊困难的绝症患者提供了一种潜在的治疗方法。然而，其临床应用和安全性仍有待进一步研究。目的：评价基于家庭的RBC-TF治疗晚期血液系统恶性肿瘤（HM）和实体瘤（ST）患者的有效性、安全性和程序特点。方法：本回顾性研究纳入了2020年7月至2025年2月期间接受家庭RBC-TF治疗的终末期HM或ST患者。使用症状缓解来评估有效性，记录不良事件（ae）来评估安全性。还分析了与癌症恶病质相关的生物标志物。所有输血均遵循标准化方案，包括用药前和使用白细胞诱导和辐照的红细胞。结果：77例患者（58例HM， 19例ST）接受了1664个单位的红细胞。HM患者在疲劳（94.1% vs. 53.8%, P = 0.003）和食欲下降（55.0% vs. 6.7%, P = 0.004）方面的症状改善明显大于ST患者。未见严重不良反应；轻度过敏反应2例（0.29%）。ST患者表现出更严重的恶病质相关标志物，包括白蛋白降低和CRP水平升高。结论：对于精心挑选的患者，特别是HM患者，基于家庭的RBC-TF是一种可行且安全的姑息性干预措施。标准化的输血方案可能有助于提高安全性。患者选择是至关重要的，特别是那些晚期恶病质患者，他们的获益可能有限。
期刊介绍：
The Journal of Pain and Symptom Management is an internationally respected, peer-reviewed journal and serves an interdisciplinary audience of professionals by providing a forum for the publication of the latest clinical research and best practices related to the relief of illness burden among patients afflicted with serious or life-threatening illness.
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