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Brief Educational Videos

Here you will find brief educational videos that cover a variety of topics related to myelodysplastic syndromes (MDS). These videos are hosted by nurses from leading treatment centers.
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Impact of Transfusions on Patients With MDS

Jayshree Shah, RN, FNP-C, AOCNP, MSN, BSN, BS, Nurse Practitioner at the John Theurer Cancer Center, Hackensack University Medical Center, discusses the impact of transfusions on your patients with myelodysplastic syndromes.

Hello, I’m Jayshree Shah, and in this video we’ll be discussing the impact of transfusions on your patients with myelodysplastic syndromes.

One of the supportive care measures we often use for MDS is a red blood cell transfusion. The primary benefit of a red blood cell transfusion is to relieve anemia, the most common cytopenia in MDS, which often causes patients to feel fatigued.1,2

However, your patients can become transfusion dependent. One study defines transfusion dependence as at least 1 red blood cell transfusion every 8 weeks over a period of 4 months.3

It’s important to know there are consequences associated with transfusion dependence.4,5 Transfusions involve frequent trips to the hospital or transfusion center, which require time and energy. This can be even more challenging for your patients if they’re already feeling fatigued.

Iron overload is also a concern. Each unit of packed red blood cells contains 200 to 250 milligrams of elemental iron. That means, as few as 20 units of packed red blood cells are enough to put your patients at risk of iron overload.4

In addition, increasing transfusion frequency can also impact your patient’s overall survival.5

In fact, one study showed that the survival of patients with transfusion dependence was significantly lower than that of patients who did not require transfusions. Patients who received as few as 2 units of blood per month showed reduced survival.5

Keeping track of your patients’ progress is very important, but can be difficult with EMR systems or when patients visit different transfusion centers. Knowing complete transfusion histories can help identify those who may be transfusion dependent or at risk of development of iron overload.4,6 To do this, explore the Nurse and Patient Resources tab of this site where you can download a patient transfusion tracker among other useful tools. Encourage your patients to keep track of their transfusions and bring the tracker with them to all appointments.

Always volunteer this information, so we need to be their advocates and probe with questions that go beyond asking how they’re feeling. Ask specific questions, like “What were you able to do before that you are not able to do now? Are you having a difficult time keeping up with chores? Are you sleeping more?” Their answers may reveal clinically relevant information to healthcare professionals before lab tests can confirm. It’s important to involve caregivers in this conversation as well, because they could observe symptoms that patients may not notice.

For more information, I encourage you to sign up at MDSCenterforNurses.com to gain access to educational resources, read more about transfusion dependence, and meet our oncology nurse experts.

References:
1. American Cancer Society. Supportive therapy for myelodysplastic syndromes. Updated July 2015. Available at: http://www.cancer.org/cancer/myelodysplasticsyndrome/detailedguide/myelodysplastic-syndromes-treating-supportive-therapy. Accessed February 18, 2016.
2. Barzi A, Sekeres MA. Myelodysplastic syndromes: A practical approach to diagnosis and treatment. Cleve Clin J Med. 2010;77(1):37-44.
3. Malcovati L, Germing U, Kuendgen A, et al. Time-dependent prognostic scoring system for predicting survival and leukemic evolution in myelodysplastic syndromes. J Clin Oncol. 2007;25(23):3503-3510.
4. List AF. Iron overload in myelodysplastic syndromes: diagnosis and management. Cancer Control. 2010;17(1S):2-8.
5. Malcovati L, Della Porta MG, Cazzola M. Predicting survival and leukemic evolution in patients with myelodysplastic syndrome. Haematologica. 2006;91(12):1588-1590.
6. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Myelodysplastic Syndromes V.1.2016. © National Comprehensive Cancer Network, Inc 2016. All rights reserved. Accessed February 11, 2016. To view the most recent and complete version of the guideline, go online to NCCN.org. NATIONAL COMPREHENSIVE CANCER NETWORK®, NCCN®, NCCN GUIDELINES®, and all other NCCN Content are trademarks owned by the National Comprehensive Cancer Network, Inc.