SynthesisCancer treatment reviews2016
How low should we go: A systematic review and meta-analysis of the impact of restrictive red blood cell transfusion strategies in oncology.
Synthesis in Cancer treatment reviews, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Restrictive versus liberal red blood cell transfusion strategies for people with haematological malignancies treated with intensive chemotherapy or radiotherapy, or both, with or without haematopoietic stem cell support.The Cochrane database of systematic reviews · 2024Pooled it
- Systematic reviews and meta-analyses comparing mortality in restrictive and liberal haemoglobin thresholds for red cell transfusion: an overview of systematic reviews.BMC medicine · 2020Pooled it
- Restrictive versus liberal red blood cell transfusion strategies for people with haematological malignancies treated with intensive chemotherapy or radiotherapy, or both, with or without haematopoietic stem cell support.The Cochrane database of systematic reviews · 2017Pooled it
- Transfusion use and effect on progression-free, overall survival, and quality of life in upfront treatment of advanced epithelial ovarian cancer: evaluation of the European Organization for Research and Treatment EORTC-55971 Cohort.International journal of gynecological cancer : official journal of the International Gynecological Cancer Society · 2023Trial
- Machine learning-based prediction of intraoperative blood transfusion in major surgery: exploiting clinical variables and systemic inflammatory indices.Annals of medicine · 2026Article
- Risk factors and outcomes of intraoperative blood transfusion in elderly patients undergoing gastrointestinal cancer surgery.World journal of gastrointestinal surgery · 2025Article
- Impact of restrictive versus liberal transfusion strategy on outcomes in patients undergoing surgery for spinal metastasis: a propensity score-matched analysis.Neurosurgical review · 2025Article
- Anemia in patients receiving anticancer treatments: focus on novel therapeutic approaches.Frontiers in oncology · 2024Review
- Explaining the Elusive Nature of a Well-Defined Threshold for Blood Transfusion in Advanced Epithelial Ovarian Cancer Cytoreductive Surgery.Diagnostics (Basel, Switzerland) · 2023Article
- Incidence of anemia and red blood cell (RBC) transfusion requirement in breast cancer.Caspian journal of internal medicine · 2023Article
- Physiology and Inflammation Driven Pathophysiology of Iron Homeostasis-Mechanistic Insights into Anemia of Inflammation and Its Treatment.Nutrients · 2021Review
- Liberal Transfusion versus Restrictive Transfusion and Outcomes in Critically Ill Adults: A Meta-Analysis.Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie · 2021Review
- Review
- Correlation between hematological parameters and outcome in patients with locally advanced cervical cancer treated by concomitant chemoradiotherapy.Cancer medicine · 2020Article
- Lifetime Transfusion Burden and Transfusion-Related Iron Overload in Adult Survivors of Solid Malignancies.The oncologist · 2020Article
- Application of Perioperative Transfusion Trigger Score in Patients Undergoing Surgical Treatment of Malignant Tumor.Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion · 2020Article
- Choosing Wisely: Decreasing the incidence of perioperative blood transfusions in gynecologic oncology.Gynecologic oncology · 2019Article
- Anemia and Iron Deficiency in Cancer Patients: Role of Iron Replacement Therapy.Pharmaceuticals (Basel, Switzerland) · 2018Review
- Transfusion practice patterns in patients with anemia receiving myelosuppressive chemotherapy for nonmyeloid cancer: results from a prospective observational study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2018Observational
- Allogenic Blood Transfusion Is an Independent Predictor of Poorer Peri-operative Outcomes and Reduced Long-Term Survival after Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: a Review of 936 Cases.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2017Observational
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundMost non-oncologic clinical practice guidelines recommend restrictive allogeneic blood transfusion practices; however, there is a lack of consensus regarding the best transfusion practice in oncology. We conducted a systematic review of the literature to compare the efficacy and safety of restrictive versus liberal transfusion strategies in patients with cancer.
methodsA literature search using MEDLINE, PUBMED and EMBASE identified all controlled studies comparing the use of restrictive with liberal transfusion in adult oncology participants up to August 10, 2015. Two review authors independently assessed studies for inclusion, extracted data and appraised the quality of the included studies. The primary outcomes of interest were blood utilization and all-cause mortality.
resultsOut of 4241 citations, six studies (3 randomized and 3 non-randomized) involving a total of 983 patients were included in the final review. The clinical context of the studies varied with 3 chemotherapy and 3 surgical studies. The overall risk of bias in all studies was moderate to high. Restrictive transfusion strategies were associated with a 36% reduced risk of receiving a perioperative transfusion (risk ratio (RR) 0.64, 95% confidence interval (CI) 0.49-0.83). There was no difference in mortality between the strategies (RR 1.00, 95% CI 0.32-3.18). There were no differences in adverse events reported between the restrictive and liberal transfusion strategies.
conclusionRestrictive strategy appears to decrease blood utilization without increasing morbidity or mortality in oncology. This review is limited by a paucity of high quality studies on this topic. Better designed studies are warranted.
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