Blood Transfusion Requirements for Patients With Sarcomas Undergoing Combined Radio- and Chemotherapy

[摘要] Patients with bony and soft tissue sarcomas may require intensive treatment with chemotherapy and radiotherapy,which often leads to a fall in haemoglobin levels, requiring blood transfusion. There may be advantages in predicting which patients will require transfusion, partly because anaemia and hypoxia may worsen the response of tumours tochemotherapy and radiotherapy. Between 1997 and 2003, a total of 26 patients who received intensive treatment withcurative intent were identified. Transfusions were given to maintain the haemoglobin at 10g/dl or above duringchemotherapy, and at 12 g/dl or above during radiotherapy. Eighteen (69%) required a transfusion, the majorityas a result of both the chemotherapy and RT criteria. There were 78 transfusion episodes, and 181 units of blood given.In the 18 patients who required transfusion, the average number of units was 10.1, but seven patients required moreblood than this. The most significant factor influencing blood transfusion was choice of intensive chemotherapy.Intensive chemotherapy and presenting Hb less than 11.6 g/dl identified 13 out of 18 patients who needed transfusion.Adding a drop in haemoglobin of greater than 1.7 g/dl after one cycle of chemotherapy identified 16 out of 18 patientswho required transfusion. The seven patients who had heavy transfusion requirements were identified by age 32 or less,intensive chemotherapy and a presenting Hb of 12 g/dl or less. Erythropoietin might be a useful alternative to transfusionin selected patient groups, especially those with heavy transfusion requirements.

[学科分类] 肿瘤学