Oral presentation at the 13th Congress of the European Hematology Association EHA (Copenhagen, 2008).

1. Author contact: pierluigi.alfieri@unimore.it

2. HOME BLOOD AND PLATELET TRANSFUSIONS AS PART OF A DOMICILIARY PROGRAM OF SUPPORTIVE CARE IN PATIENTS WITH BLOOD MALIGNANCIES: AN ITALIAN SINGLE-CENTRE EXPERIENCE Alfieri P, Favale E, De Palma M, Torelli G Simultaneous session, Hall C4, 14 th June Vascular biology, bleeding disorders and transfusion medicine

4. COMMUNITY HEALTH TRUST General practitioners Community nurses On-call doctors AIL HOME CARE TEAM Haematologist Specialist nurse PATIENT’S HOME Patient Caregiver UNIVERSITY HOSPITAL TRUST Division of Haematology Transfusion Centre Centralised Laboratory Services

9. Patients’ characteristics - Age Median age = 75 yrs

10. Patients’ characteristics - Diagnosis

11. Patients’ characteristics - Prognosis

12. Duration of home care and survival DURATION OF HOME CARE (days) Patients deceased: 138 OS < 90 days: 64 pts OS 90-180 days: 21 pts OS 180-360 days: 30 pts OS > 360 days: 23 pts Median OS: 195 days 0 90 180 270 360 450 540 630 720 810 900 990 1080 1170 1260

13. No. transfusions per diagnosis (1) 22 6 16 4 HL 77 0 77 5 OTHER CHRONIC ANAEMIAS 32 12 20 3 AA 148 47 101 21 NHL 4 12 22 23 25 42 No. pts 39 19 20 ALL 70 35 35 CLL 276 79 197 MM 335 78 257 MPD 473 92 381 MDS 605 302 303 AML RBC + PC PC RBC Diagnosis

14. No. transfusions per diagnosis (2)

15. No. transfusions per disease status n=83 n=43 n=26 n=9

16. No. transfusions per home care cycle 6.5 240 88 152 37 NHL / HL / CLL 18.5 425 32 393 23 Chronic phase 35 642 975 RBC + PC 2077 276 335 582 644 RBC + PC 15 183 458 43 Advanced phase Median No. PC RBC No. pts Prognostic group 4 7 28 9 In causal therapy 83 161 22 23 33 46 No. pts 11.5 448 527 Terminal phase 13 670 1407 TOTAL 12.5 79 197 MM 14.5 78 257 MPD 17.5 104 478 MDS / ANAEMIAS 14 321 323 AML / ALL Median No. PC RBC Diagnosis

18. Transfusion products: erythrocytes 0.066 +/- 0.09 billions 0.51 +/- 0.43 billions Leukocyte content 54 +/- 6 59 +/- 10 Haematocrit (%) 57 +/- 10 55 +/- 8 Haemoglobin content (gr) 296 +/- 37 300 +/- 20 Volume (ml) Filtrated erythrocytes (leukodepleted) n=158 Erythrocytes without Buffy-Coat resuspended in SAG (leukoreduced) n=99

19. Transfusion products: platelets 7.39 +/- 0.06 7.27 +/- 0.05 pH 2.89 +/- 0.5 x 10 11 2.76 +/- 0.4 x 10 11 Platelet content 0.056 +/- 0.03 billions 0.062 +/- 0.04 billions Leukocyte content 337 +/- 24 342 +/- 40 Volume (ml) Multicomponent Apheresis Platelets n=25 Pooled Buffy-Coat Platelets n=556

20. 4 5 6 RBC/PC bags collected at Blood Bank Appropriate storage and transport Pre-transfusion clinical assessment Antiallergic premedication before PC Bed-assistance for the first 15 minutes … Next patient On-call service in case of emergency 7 Caregiver trained to remove needles, manage catheters and dispose bags

25. www.ailmodena.it