Perfil clínico, laboratorial e transfusional de pacientes oncológicos ambulatoriais: análise de três anos em hospital público brasileiro

Abstract

Cancer represents a major public health concern and is frequently associated with hematological alterations resulting from both the disease itself and the therapies employed. In this context, transfusion support and the evaluation of laboratory parameters play a central role in the clinical management of these patients. This study aimed to characterize the clinical, laboratory, and transfusional profile of outpatient cancer patients treated at a public hospital in Brazil. This was a retrospective observational study including 389 patients treated between January 2020 and December 2022. The population had a median age of 62 years, with a slight predominance of females (53%). Solid tumors accounted for 52.9% of cases, followed by lymphoid (31.4%) and myeloid neoplasms (15.4%). During the study period, a total of 677 units of blood components were transfused, predominantly red blood cells concentrates (81.4%), with a median of two units per patient. Anemia was the main indication for transfusion (74.1%). Laboratory evaluation revealed consistent hematological abnormalities, including increased red cell distribution width (RDW), suggesting significant erythrocyte morphological heterogeneity. Additionally, elevated neutrophil-to-lymphocyte ratio (NLR) and platelet-to- lymphocyte ratio (PLR) indicated the presence of systemic inflammation. In the transfusional analysis, patients with solid tumors showed a higher intensity of red blood cell transfusion, whereas those with hematological neoplasms exhibited a higher frequency of platelet transfusion. Notably, platelet transfusion intensity was higher in patients with solid tumors, while among hematological neoplasms, the lymphoid subgroup demonstrated a greater relative demand for this component. Irregular antibody positivity was identified in 4.1% of patients, with a predominance of alloantibodies from the Rh and Kell systems. The occurrence of transfusion reactions was low, with three events reported. In conclusion, outpatient cancer patients present a high transfusional demand, with distinct patterns according to the type of neoplasm, as well as laboratory findings consistent with systemic inflammation and erythropoietic dysregulation. These findings highlight the importance of individualized transfusion strategies and contribute to improving clinical care in this population.