The efficacy of administering blood transfusions at home to terminally ill cancer patients.

Comfort care for cancer patients in the terminal stage has been the goal of hospice programs since their inception. Among the many treatment modalities available to homebound patients, transfusions have been little studied for their effects on advanced disease symptoms, particularly for those in the terminal phase. Our work in a hospital-based home care program established in 1978 led us to believe that blood transfusions neither slowed the progress of symptoms nor relieved their severity. Our hypothesis being that transfusions do not improve or significantly change the quality of life of terminally ill patients, we studied 24 men and women with various forms of advanced cancer. The only significant clinical difference between pre- and post-transfusion variables was in hematocrit. In the subjective testing, the only significant difference was in the quality of life index completed by the patient. This result could be interpreted as a positive psychological benefit from blood transfusions. The results of other subjective tests, although statistically less significant, also showed a trend toward psychological benefit from transfusions. It would be necessary to carry out studies with a larger sample to conclude that this is indeed the case.