Hospitalizations for Post-Chemotherapy Red Blood Cell Transfusions in France, 2017–2020

OBJECTIVES: Anemia is a severe complication of chemotherapy administration. Treatment of anemia increases hemoglobin levels, reduces the need for red blood cell (RBC) transfusions and improves patients' quality of life. The objective of this study was to estimate the clinical and economic impact of hospitalizations for red blood cell transfusions among cancer patients treated with chemotherapy.

METHODS: Patients diagnosed with incident cancers and treated by intravenous chemotherapy were identified from a French nationwide database (PMSI 2017–2020). All clinical and economic data were collected from the database. Incidence proportion of patients receiving a RBC transfusion, inpatient mortality, health care resources use, and cost were calculated overall and by cancer type.

RESULTS: Between 2017 and 2020, between 176,520 and 182,695 people were diagnosed with incident cancers and treated by intravenous chemotherapy. Incidence proportion of patients receiving RBC transfusion was stable. In 2020, a hospitalization for RBC transfusion involved 27,819 patients, representing a hospitalization rate of 15.2% among newly diagnosed cancer patients treated with chemotherapy. The incidence of RBC transfusion ranged from 5.6% in breast cancer patients to 22.4% in ovarian cancer patients for solid tumors, and 24.1% for hematological tumors. A total of 2319 in-hospital deaths occurred, corresponding to a mortality rate of 8.3%. This rate varied according to the type of cancer from 6,5% for hematological tumors to 8.5% for solid tumors. A total of 51,234 stays were generated, with an average duration of 5.9 ± 11.6 days. The average cost of a stay per patient was €946 (€911 for solid tumors and €1013 for hematological tumors). The overall cost of RBC transfusion hospitalizations amounted to more than €24 million in 2020 (+€2 million vs 2017).

CONCLUSIONS: The number of hospitalizations and costs for RBC transfusion among cancer patients treated with chemotherapy is still rising.