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

Aim. To study the quality of life (QL) of patients with oncohematological diseases and anemia with respect to hemoglobin level and to evaluate the effi cacy of red blood cell transfusion (RBCT). Materials & Methods. QL of patients (n = 326) was studied using FACT-An questionnaire. RBCT effi cacy was evaluated in two groups. The fi rst 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 fi rst 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 fi rst 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 eff ect of the severity of anemia on QL was demonstrated. The patients with Hb < 80 g/L were shown 266 Н.А. Романенко и др. КЛИНИЧЕСКАЯ ОНКОГЕМАТОЛОГИЯ Заключение. Показана зависимость КЖ от тяжести анемии. У пациентов с уровнем Hb < 80 г/л КЖ низкое. Установлено важное значение определения SvO2 у больных с анемией для оценки эффективности ТЭ. При низком SvO2 (< 60 %) необходимо продолжить ТЭ до уровня Hb 100 г/л и Ht 33 %. Ключевые слова: анемия, хроническая анемия, трансфузии эритроцитов, концентрация гемоглобина, гематокрит, насыщение венозной крови кислородом, качество жизни, опросник FACT-An. Получено: 10 марта 2018 г. Принято в печать: 30 мая 2018 г. Для переписки: Николай Александрович Романенко, д-р мед. наук, ул. 2-я Советская, д. 16, Санкт-Петербург, Российская Федерация, 191024; тел.: 8(812)717-58-57; факс: 8(812)717-67-80; е-mail: rom-nik@yandex.ru Для цитирования: Романенко Н.А., Чечеткин А.В., Жигулева Л.Ю. и др. Коррекция анемии и оценка эффективности трансфузий эритроцитов у пациентов с онкогематологическими заболеваниями. Клиническая онкогематология. 2018;11(3):265–72. DOI: 10.21320/2500-2139-2018-11-3-265-272 to have low quality of life. SvO2 determination in anemia patients proved to be of great importance for RBCT effi cacy 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.