Home Blood Transfusions
A Pilot Study of Home Blood Transfusions for Patient With Cancer Who Have Transfusion Dependent Cytopenias
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Adam Binder, MD
- Phone Number: 215-955-8874
- Email: adam.binder@jefferson.edu
Study Locations
-
-
Pennsylvania
-
Philadelphia, Pennsylvania, United States, 19107
- Recruiting
- Thomas Jefferson University Hospital
-
Contact:
- Adam Binder, MD
- Phone Number: 215-955-8874
- Email: adam.binder@jefferson.edu
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Individuals must meet all of the following inclusion criteria in order to be eligible to participate in the study:
- Provide signed and dated informed consent form Willing to comply with all study procedures and be available for the duration of the study
- Male or female, over the age of 18
- Must meet definition of transfusion dependence (require at least 2 blood product transfusions over a 28-day period)
- Receive their cancer care at SKCCC
- Have a history of blood product transfusions and NO history of transfusion reactions,
- Live within a 30-mile range of the Center City SKCCC location.
- Must be willing to allow people into the home
Exclusion Criteria:
- An individual who meets any of the following criteria will be excluded from participation in this study:
- Patients who have a history of a transfusion reaction
- Heart failure as defined by AHA stage C or NYHA Class II-IV
- Non-English or Spanish speaking
- Are unhoused
- Are incarcerated
- Have poor venous access
- Diagnosis of Solid Tumor malignancy
- Women who are pregnant
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Experimental - Home Blood Transfusion
Participants will receive 1-2 blood products transfused in the home each week for a total of 5 transfusions.
Participants with known RBC antibodies will only be eligible to receive platelet transfusions at home.
Research nurse comes to home early to draw CBC and Type and Screen.
Infusion nurse delivers blood products to home.
Blood product administered.
Assess vital signs following administration of blood products.
Perform feasibility, acceptability, appropriateness questionnaires.
Complete qualitative semi-structured interviews.
|
Participants will be provided with transfusion of blood products, specifically red blood cells and platelets, in the home setting.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Feasibility of a home blood transfusion program utilizing the RE-AIM framework
Time Frame: 5 weeks
|
The feasibility of the program defined as greater than 80% of home blood product transfusions occur as planned.
|
5 weeks
|
|
Acceptability of a home blood transfusion program utilizing the RE-AIM framework
Time Frame: 5 weeks
|
Surveys and qualitative interviews will be completed to better understand acceptability of the program. Acceptability will be measured using the acceptability of intervention measure. Based on a 5-point Likert scale. Score range: 1 (Completely Disagree) to 5 (Completely Agree) |
5 weeks
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Evaluate patient perspective of home blood transfusions via qualitative analysis.
Time Frame: Within 3 weeks of final home transfusion
|
Evaluate patient perspective of home blood transfusions via qualitative analysis.
Semi-structured interviews will be evaluated through qualitative analysis.
All interviews will be digitally recorded and transcribed.
Interviews will be analyzed using NVIVO software for coding and analysis.
The codebook will be developed using conventional content analysis.
All members of the research team will read the first three transcripts and identify concepts, leading to the initial code structure.
This initial code structure will be applied to subsequent interviews by two coders and refined to include new themes as they emerge.
This iterative process will continue until coders and at least one other team member agree upon a final coding structure, with discrepancies resolved through consensus.
The two coders will apply the final structure to all transcripts.
Coders will double code about 30-40% of the transcripts.
Intercoder reliability will be calculated in NVivo 12 using the κ coefficient.
|
Within 3 weeks of final home transfusion
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Adam Binder, MD, Adam.Binder@jefferson.edu
Publications and helpful links
General Publications
- Weiner BJ, Lewis CC, Stanick C, Powell BJ, Dorsey CN, Clary AS, Boynton MH, Halko H. Psychometric assessment of three newly developed implementation outcome measures. Implement Sci. 2017 Aug 29;12(1):108. doi: 10.1186/s13012-017-0635-3.
- Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005 Nov;15(9):1277-88. doi: 10.1177/1049732305276687.
- Viera AJ, Garrett JM. Understanding interobserver agreement: the kappa statistic. Fam Med. 2005 May;37(5):360-3.
- Vijenthira A, Starkman R, Lin Y, Stanworth SJ, Bowen D, Harrison L, Wintrich S, Callum J, Buckstein R. Multi-national survey of transfusion experiences and preferences of patients with myelodysplastic syndrome. Transfusion. 2022 Jul;62(7):1355-1364. doi: 10.1111/trf.16946. Epub 2022 Jun 10.
- Garcia D, Aguilera A, Antolin F, Arroyo JL, Lozano M, Sanroma P, Romon I. Home transfusion: three decades of practice at a tertiary care hospital. Transfusion. 2018 Oct;58(10):2309-2319. doi: 10.1111/trf.14816. Epub 2018 Sep 19.
- Niscola P, Tendas A, Giovannini M, Cupelli L, Trawinska MM, Palombi M, Scaramucci L, Brunetti GA, Perrotti A, Neri B, Efficace F, Cartoni C, de Fabritiis P, Mandelli F. Transfusions at home in patients with myelodysplastic syndromes. Leuk Res. 2012 Jun;36(6):684-8. doi: 10.1016/j.leukres.2012.01.010. Epub 2012 Feb 14.
- Charron J, Gouezec H, Bajeux E. [Home blood transfusion in France: Benefits and development terms]. Transfus Clin Biol. 2019 Nov;26(4):304-308. doi: 10.1016/j.tracli.2018.08.161. Epub 2018 Sep 12. French.
- LeBlanc TW, Egan PC, Olszewski AJ. Transfusion dependence, use of hospice services, and quality of end-of-life care in leukemia. Blood. 2018 Aug 16;132(7):717-726. doi: 10.1182/blood-2018-03-842575. Epub 2018 May 30.
- Odejide OO, Steensma DP. Patients with haematological malignancies should not have to choose between transfusions and hospice care. Lancet Haematol. 2020 May;7(5):e418-e424. doi: 10.1016/S2352-3026(20)30042-9.
- Thompson HW, McKelvey J. Home blood transfusion therapy: a home health agency's 5-year experience. Transfusion. 1995 May;35(5):453. doi: 10.1046/j.1537-2995.1995.35595259158.x. No abstract available.
- Koepke MD, Nyman JA, Koepke JA. Home blood transfusions: the medical, economic, and legal issues surrounding a new treatment procedure. J Health Polit Policy Law. 1988 Fall;13(3):565-79. doi: 10.1215/03616878-13-3-565.
- Benson K, Popovsky MA, Hines D, Hume H, Oberman HA, Glassman AB, Pisciotto PT, Thurer RL, Stehling L, Anderson KC. Nationwide survey of home transfusion practices. Transfusion. 1998 Jan;38(1):90-6. doi: 10.1046/j.1537-2995.1998.38198141505.x.
- de Swart L, Smith A, Johnston TW, Haase D, Droste J, Fenaux P, Symeonidis A, Sanz G, Hellstrom-Lindberg E, Cermak J, Germing U, Stauder R, Georgescu O, MacKenzie M, Malcovati L, Holm MS, Almeida AM, Madry K, Slama B, Guerci-Bresler A, Sanhes L, Beyne-Rauzy O, Luno E, Bowen D, de Witte T. Validation of the revised international prognostic scoring system (IPSS-R) in patients with lower-risk myelodysplastic syndromes: a report from the prospective European LeukaemiaNet MDS (EUMDS) registry. Br J Haematol. 2015 Aug;170(3):372-83. doi: 10.1111/bjh.13450. Epub 2015 Apr 24.
- Cannas G, Fattoum J, Raba M, Dolange H, Barday G, Francois M, Elhamri M, Salles G, Thomas X. Transfusion dependency at diagnosis and transfusion intensity during initial chemotherapy are associated with poorer outcomes in adult acute myeloid leukemia. Ann Hematol. 2015 Nov;94(11):1797-806. doi: 10.1007/s00277-015-2456-2. Epub 2015 Jul 23.
- Jiang C, Yabroff KR, Deng L, Wang Q, Perimbeti S, Shapiro CL, Han X. Self-reported Transportation Barriers to Health Care Among US Cancer Survivors. JAMA Oncol. 2022 May 1;8(5):775-778. doi: 10.1001/jamaoncol.2022.0143.
- Doshi R, Gonzalez KM, Hossain A, Gentsch AT, Vivero A, Wilde L, Rising KL, Binder AF. MD Perceptions of a home blood transfusion program among patients with hematologic malignancies who are newly diagnosed as compared to those with relapsed/refractory disease American Society of Hematology Conference 2023
- Andersen SK, Croxford R, Earle CC, Singh S, Cheung MC. Days at Home in the Last 6 Months of Life: A Patient-Determined Quality Indicator for Cancer Care. J Oncol Pract. 2019 Apr;15(4):e308-e315. doi: 10.1200/JOP.18.00338. Epub 2019 Mar 8.
- Banerjee R, George M, Gupta A. Maximizing Home Time for Persons With Cancer. JCO Oncol Pract. 2021 Sep;17(9):513-516. doi: 10.1200/OP.20.01071. Epub 2021 Mar 4. No abstract available.
- Saleem R, MacDougall K, Hassan A, et al. Novel Home-Based Transfusion Model of Palliative Care in Malignant Hematology. Blood (2022) 140 (Supplement 1): 11024- 11025.
- Craig JI, Milligan P, Cairns J, McClelland DB, Parker AC. Nurse practitioner support for transfusion in patients with haematological disorders in hospital and at home. Transfus Med. 1999 Mar;9(1):31-6. doi: 10.1046/j.1365-3148.1999.009001031.x.
- Barki-Harrington L, Baron-Epel O, Shaulov A, Akria L, Barshay Y, Dally N, Deshet D, Inbar T, Koren-Michowitz M, Leiba M, Moshe Y, Shvidel L, Tadmor T, Yagenah S, Zektser M, Preis M, Hellman I, Yahalom V, Aviv A. Willingness and concerns of transfusion-dependent hematological patients toward the option of home transfusion therapy. Palliat Med. 2021 May;35(5):927-932. doi: 10.1177/02692163211000634. Epub 2021 Mar 24.
- Athilingam P, D'aoust R, Zambroski C, et al. Predictive Validity of NYHA and ACC/AHA Classifications of Physical and Cognitive Functioning in Heart Failure, International Journal of Nursing Science, Vol. 3 No. 1, 2013, pp. 22-32. doi: 10.5923/j.nursing.20130301.04.
- Yao R, Zhang W, Evans R, Cao G, Rui T, Shen L. Inequities in Health Care Services Caused by the Adoption of Digital Health Technologies: Scoping Review. J Med Internet Res. 2022 Mar 21;24(3):e34144. doi: 10.2196/34144.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- iRISID-2024-1731
- JT 44575 (Other Identifier: JeffTrial Number)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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