Impact Of Hemoglobin Level And Self-Reported Symptom Burden In Patients With Lung Cancer.

e17692 Background: There has been limited research defining the differences between the effects of liberal (8-10 g/dL) and restrictive (7-8 g/dL) transfusion hemoglobin thresholds on outcomes of ambulatory patients with cancer. Methods: As part of routine work-flow, all patients with a cancer diagnosis were asked to complete an electronic, patient self-reported survey using the validated MD Anderson Symptom Inventory (MDASI) at each ambulatory physician encounter in Medical and Radiation Oncology at two centers within Geisinger Health System. Analysis was restricted to patients with a diagnosis of lung cancer, because it was thought that this population would experience the effects of anemia most acutely. Each MDASI completed was matched with the laboratory-reported hemoglobin specific to that day. Results: There were 850 MDASI completed between 1/22/14 and 1/16/15 for which there was a corresponding hemoglobin result. There were 256 MDASI from 147 individual patients with lung cancer (Table 1). Applying a Minimal Important Difference, MID, (previously validated for this tool) of 0.98 to 1.21 for the symptoms of fatigue, shortness of breath, general activity, mood, and work interference, there was no significant difference noted between hemoglobin levels of 8-12 g/dL. This observation did not change when patients were stratified by age. There were insufficient responses from patients with Hgb < 8.0 g/dL. Conclusions: There was no significant difference in the symptoms of fatigue, shortness of breath, general activity, mood, and work interference with hemoglobin levels of 8-12 g/dL as self-reported by patients. There were insufficient responses to draw conclusions about patients with hemoglobin levels less than 8 g/dL. Results are consistent with the current ASH and ASCO guidelines for transfusion of patients with cancer. MDASI values from patients w/ lung cancer and anemia. HEMOGLOBIN VALUE SURVEYS PATIENTS PATIENTS W/ LUNG CANCER FATIGUE AVERAGE SHORTNESS OF BREATH AVERAGE GENERAL ACTIVITY AVERAGE MOOD AVERAGE WORK AVERAGE 7-7.99 1 1 1 10.0 8.0 3.0 10.0 8.0 8-8.99 21 20 20 6.0 4.6 4.7 3.9 5.0 9-9.99 31 25 25 5.3 4.4 4.7 3.2 4.6 10-11.99 72 52 52 4.7 3.6 4.1 3.2 4.1 12+ 131 86 86 5.0 3.5 3.4 2.8 3.5 TOTAL 256 147 147 5.1 3.7 3.9 3.1 4.0