Home Transfusion Program for Blood Cancers

Recruiting at 1 trial location

Overseen By Oreofe Odejide, MD, MPH

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Dana-Farber Cancer Institute

Disqualifiers: Already in hospice, Nursing home, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 6 months

700 Participants Needed

Trial Summary

What is the purpose of this trial?

This research study is evaluating whether a new care delivery program that provides access to home blood transfusions in hospice (i.e, HEME-Hospice) compared to regular standard of care improves quality of life, mood, and end-of-life health care utilization for patients with hematologic malignancies.

Do I need to stop my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What data supports the effectiveness of the HEME-Hospice Program treatment for blood cancers?

The research suggests that combining blood transfusions with hospice care can improve the quality of life for patients with blood cancers, as transfusions help manage symptoms like fatigue and breathlessness. Additionally, patients receiving transfusions in hospice settings have shown longer survival times, especially when treated as outpatients. ^{1 2 3 4 5}

Is the Home Transfusion Program for Blood Cancers safe for humans?

Research suggests that home transfusions can be safe and convenient for patients with advanced cancer or chronic conditions, even in a home setting. ^{1 3 6 7 8}

How is the Home Transfusion Program for Blood Cancers different from other treatments for blood cancers?

The Home Transfusion Program for Blood Cancers is unique because it allows patients to receive blood transfusions at home instead of in a hospital, which can improve their quality of life by reducing the need for difficult and costly hospital visits. This approach is particularly beneficial for patients with chronic anemia who require regular transfusions, offering a safe and convenient alternative to traditional in-hospital care. ^{8 9 10 11 12}

Research Team

Oreofe O. Odejide, MD

Principal Investigator

Dana-Farber Cancer Institute

Eligibility Criteria

This trial is for patients with blood-related cancers like leukemia, myelodysplastic syndrome, multiple myeloma, and lymphoma. Participants should be in need of hospice care and could benefit from home blood transfusions.

Inclusion Criteria

My blood cancer has returned or is not responding to treatment.

I am the primary caregiver for someone with blood cancer.

Receipt of primary oncologic care at DFCI (at least 2 outpatient visits in 12 months prior to enrollment)

Exclusion Criteria

I am a caregiver and I am under 18 years old.

Already enrolled in hospice

Resides in nursing home or assisted living facility

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive either HEME-Hospice care with home transfusions or usual care based on their oncologist's assignment

6 months

At least once weekly assessment of symptoms

Follow-up

Participants are monitored for quality of life, mood, and healthcare utilization after treatment

6 months

Treatment Details

Interventions

• HEME-Hospice Program

Trial Overview The study is testing a new HEME-Hospice Program that offers home blood transfusions to see if it improves quality of life, mood, and reduces hospital visits at the end of life compared to usual care.

Participant Groups

Group I: Arm 1: Access to home blood transfusions while enrolled in hospice (HEME-Hospice care) Experimental Treatment 1 Intervention

Participants assigned to access to HEME-Hospice care who enroll in hospice will have at least once weekly assessment of symptoms of anemia and thrombocytopenia by the study team and will receive transfusions at home as indicated. Individualized care appointments with hospice care team providers, and frequency of visits are determined by individual participant need.

Group II: Arm 2: Usual Care Active Control 1 Intervention

Participants assigned to usual care will receive standard oncology care delivered by the hematologic oncologists. Participants will have access to regular/standard hospice care if they elect to enroll in hospice.

Who Is Running the Clinical Trial?

Dana-Farber Cancer Institute

Lead Sponsor

Trials

1,128

Recruited

382,000+

National Cancer Institute (NCI)

Collaborator

Trials

14,080

Recruited

41,180,000+

Findings from Research

A case series involving 101 transfusion procedures for six pediatric patients showed that home transfusions for those in Pediatric Palliative Care were safe, with no reported adverse effects.

Families expressed high satisfaction with home transfusions, appreciating the convenience and reduced disruption to daily life, while the program also resulted in cost savings for the Regional Health System.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Safety and Feasibility of Home Transfusions in Pediatric Palliative Care: A Preliminary Report. De Zen, L., Del Rizzo, I., Vendrametto, V., et al.[2022]

Home blood transfusion can significantly improve the comfort and quality of life for patients with chronic anemia by allowing them to avoid the difficult and costly transportation to hospitals for transfusions.

The practice has shown to have few mild adverse events, but its development was previously hindered by a lack of funding and framework until new recommendations were published in 2018, suggesting a potential for growth in this area of healthcare.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Home blood transfusion in France: Benefits and development terms]. Charron, J., Gouëzec, H., Bajeux, E.[2020]

References

1. England pubmed.ncbi.nlm.nih.gov

Patients with haematological malignancies should not have to choose between transfusions and hospice care. [2020]

2. England pubmed.ncbi.nlm.nih.gov

Oncologists say hospice is best place for blood cancer care. [2019]

3. England pubmed.ncbi.nlm.nih.gov

Blood transfusions for anaemia in patients with advanced cancer. [2021]

4. United States pubmed.ncbi.nlm.nih.gov

An Anecdotal Outpatient Approach to Caring for Patients With End-Stage Hematologic Malignancies. [2023]

5. United States pubmed.ncbi.nlm.nih.gov

Survey of blood transfusion practice for palliative care patients in Yorkshire: implications for clinical care. [2018]

6. Israel pubmed.ncbi.nlm.nih.gov

[Complementary medicine in hemato-oncology care: review of controlled clinical studies]. [2011]

7. United States pubmed.ncbi.nlm.nih.gov

Transfusion dependence, use of hospice services, and quality of end-of-life care in leukemia. [2022]

8. United States pubmed.ncbi.nlm.nih.gov

Safety and Feasibility of Home Transfusions in Pediatric Palliative Care: A Preliminary Report. [2022]

9. Italy pubmed.ncbi.nlm.nih.gov

Home care management of patients affected by hematologic malignancies: a review. [2006]

10. Japan pubmed.ncbi.nlm.nih.gov

[Home care of hematological malignancies]. [2013]

11. France pubmed.ncbi.nlm.nih.gov

[Home blood transfusion in France: Benefits and development terms]. [2020]

12. United States pubmed.ncbi.nlm.nih.gov

Home chemotherapy for children with cancer. [2019]