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Anemia
Volume 2016, Article ID 8494738, 7 pages
http://dx.doi.org/10.1155/2016/8494738
Review Article

Transfusion Thresholds, Quality of Life, and Current Approaches in Myelodysplastic Syndromes

Haematology Department, NHS Lothian, Edinburgh EH4 2XU, UK

Received 28 December 2015; Accepted 4 April 2016

Academic Editor: Aurelio Maggio

Copyright © 2016 Ioannis Koutsavlis. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Hemoglobin thresholds and triggers for blood transfusions have changed over the years moving from a higher to a lower level. This review article summarizes the current evidence of transfusion thresholds in the hospitalized as well as in the outpatient setting and particularly in myelodysplasia. Fatigue is the main reported symptom in this group of patients and current clinical trials are looking for a more liberal approach of red cell transfusion and the effect on quality of life as opposed to the restrictive strategy used in the critical care setting. Practical considerations, the cost effectiveness of this strategy in addition to the possible complications, and the use of quality of life questionnaires have also been reviewed.