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STEPHENSON CANCER CENTER, OBI, HOSPICE AGENCIES PARTNER ON CLINICAL TRIAL
STUDYING HOME-BASED BLOOD TRANSFUSIONS

News Provided By
Price Lang
April 14, 2022, 15:36 GMT
Share This Article


OKLAHOMA CITY, OKLAHOMA, USA, April 14, 2022 /EINPresswire.com/ -- When Patrisha
Nicholson of Edmond decided to discontinue treatment for acute myeloid leukemia,
she agreed to enroll in a pioneering study being offered by OU Health Stephenson
Cancer Center in conjunction with the Oklahoma Blood Institute and local
hospices. The study is unique in that it is not testing a new drug, but a means
of improving quality of life in a patient’s last weeks or days of life.

Nicholson was exactly the type of patient for which the trial was designed: a
person with a hematologic malignancy (blood cancer) who no longer wanted to be
treated for her cancer, but still needed to have blood and platelet transfusions
to relieve crushing fatigue and prevent bleeding and bruising. However, very few
such patients enter hospice care, nor do hematologists typically recommend
hospice. That’s largely because almost no hospice agencies provide blood and
platelet transfusions in a patient’s home.

While blood and platelet transfusions are technically covered by Medicare,
hospice agencies face a number of barriers in providing the service. That means
patients and their families often forgo supportive hospice services and instead
make frequent trips to a hospital or clinic for transfusions that take several
hours. If the hospital or clinic is many miles away, they lose even more
precious time at home with family and friends. In some cases, patients might
decide they are too tired to even make the trip, and their quality of life and
health declines further.

OU Health hematologist-oncologist Jennifer Holter-Chakrabarty, M.D., was all too
familiar with these barriers and decided to develop a local study after serving
on the government affairs committee of the American Society of Hematology, which
is advocating for change at the national level. She and OU Health palliative
care physician and oncology fellow Rabia Saleem, M.D., designed the study, which
aims to evaluate whether home-based transfusions improve the patient’s quality
of life. They hope this might serve as evidence that this therapy should be
considered for hematologic patients and provide rationale for a federal
reimbursement model to hospice agencies. The study is a collaboration with the
Oklahoma Blood Institute, which is providing the blood, lab testing and nursing
staff to perform transfusions, as well as two local hospices, Integris Hospice
and Apex Home Health and Hospice, which are overseeing care and collecting data.

“When my patients are being treated for cancers like leukemia or myeloma, they
usually receive a significant dose of chemotherapy, which keeps their bone
marrow from working well, and they require blood transfusions two or three times
per week. In addition, their disease disrupts normal marrow function that
produces red blood cells and platelets. If they want to transition to hospice,
the need for transfusions doesn’t go away,” Holter-Chakrabarty said. “Patients
often feel exhausted and are so short of breath that just getting up and walking
to the door is a task they can’t contemplate. Many of my patients tell me that
after they get a unit of blood, they have enough energy to get up and make a
meal or spend time with family. They get more of their life back.”

In the study, patients’ symptoms determine when they need a transfusion of blood
or platelets, which is the opposite of what occurs in a hospital or clinic,
where a patient’s lab results for hemoglobin or platelets determine whether a
transfusion is needed. Not all patients have symptoms at the same hemoglobin or
platelet level, Holter-Chakrabarty said, and they have experienced enough
transfusions to know when they need one. Each week, study participants receive
blood products based on an evaluation of symptoms like fatigue, shortness of
breath, bruising or bleeding.

“We wanted to flip the script and give the patient control,” she said. “Because
this is aimed at palliative, supportive, patient-centered care, then the
patients’ symptoms should trigger a transfusion, not a number. We are also
collecting blood each week so that at the end of the study we’ll be able to see
how those trigger levels compare to symptoms.”

The study is also addressing the safety of home-based transfusions. Concerns
about transfusion reactions have favored transfusions being conducted in a
hospital or clinic instead of a home setting, Holter-Chakrabarty said. However,
reactions are rare, and studies conducted in Europe — where home hospice
transfusions are routine — show a reaction rate of less than 1%.

John Armitage, M.D., CEO of Oklahoma Blood Institute, said the study is a
perfect fit for OBI’s mission of saving lives and improving quality of life. As
the sixth-largest nonprofit blood collector in America, OBI is able to provide
units of blood and lend leadership in advocating for the effort. Armitage said
he hopes the study’s evidence will ultimately allow patients to enroll in
hospice earlier when they are ready to take that step.

“This model allows patients to receive the palliative benefits of blood
transfusions sooner rather than starting hospice in the last week of their
lives,” he said. “These patients have every right to comfort and family time.
Local organizations are working together to remove this barrier. This is why you
go into healthcare — to give better care and use your knowledge to improve life
for people.”

The study’s intention is also likely to resonate with blood donors. “It’s easy
for donors to understand that someone might need blood after a car accident, for
example, but this allows our donors to see that they give good days to people in
addition to saving lives,” he said.

That sense of purpose was also meaningful to Patrisha Nicholson, who spent seven
weeks in hospice before passing away at age 83. She was the first patient
enrolled in the trial and was grateful to be part of something that not only
benefited her but could enhance care for others in the future, her daughter
Jennifer Steuber said. Her mother received weekly blood transfusions at home and
was comfortable and engaged up until a few days before her death.

“I truly believe we wouldn’t have had her for seven weeks had she not been part
of the study,” Steuber said, “nor would she have had her quality of life for
that long without the transfusions. She was a very social person, and although
COVID-19 complicated things, she had neighbors and relatives come over with
their masks on, and someone from church brought her communion. She was often
able to get up and sit at the dinner table and was very animated.

“Being part of the study was also important to her because she was a pioneer in
other areas of her life. She was an educator and was active in civil rights as
it pertained to desegregation of the Oklahoma City public school system, and she
was the first female athletic director for the entire district. Paving the way
for others was her calling.”

###

OU HEALTH
OU Health is the state’s only comprehensive academic health system of hospitals,
clinics and centers of excellence. The flagship academic healthcare system is
the clinical partner of the University of Oklahoma Health Sciences Center, one
of the most comprehensive academic and research campuses in the country. With
10,000 employees and more than 1,300 physicians and advanced practice providers,
OU Health is home to Oklahoma’s largest doctor network with a complete range of
specialty care. OU Health serves Oklahoma and the region with the state’s only
freestanding children’s hospital, the only National Cancer Institute-Designated
OU Health Stephenson Cancer Center and Oklahoma’s flagship hospital, which
serves as the state’s only Level 1 trauma center. OU Health’s oncology program
at OU Health Stephenson Cancer Center was named Oklahoma’s top facility for
cancer care by U.S. News & World Report in its 2020-21 rankings. OU Health also
was ranked by U.S. News & World Report as high performing in these specialties:
Colon Surgery, COPD and Congestive Heart Failure. OU Health’s mission is to lead
healthcare in patient care, education and research. To learn more, visit
ouhealth.com.

Oklahoma Blood Institute
Oklahoma Blood Institute is the sixth largest nonprofit blood collector in
America and Oklahoma’s local blood supplier, supporting the inventory for
patients in more than 160 hospitals, medical facilities, and air ambulances
statewide. For more information, visit obi.org.

Carson Cunningham
Oklahoma Blood Institute
carson.cunningham@obi.org

You just read:


STEPHENSON CANCER CENTER, OBI, HOSPICE AGENCIES PARTNER ON CLINICAL TRIAL
STUDYING HOME-BASED BLOOD TRANSFUSIONS

News Provided By
Price Lang
April 14, 2022, 15:36 GMT
Share This Article


Distribution channels: Healthcare & Pharmaceuticals Industry, Science


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Submit your press release
Contact
Carson Cunningham
Oklahoma Blood Institute
carson.cunningham@obi.org
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Stephenson Cancer Center, OBI, Hospice Agencies Partner on Clinical Trial
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