Remote monitoring in chronic anaemia: towards personalized transfusion strategies

Abstract

This thesis investigates how haemoglobin levels influence physiology and quality of life in patients with chronic anaemia, and whether wearable biosensors can support more personalized red blood cell transfusion strategies. Current transfusion practice varies considerably, partly because evidence for optimal transfusion thresholds in chronically transfusion-dependent patients is limited.

An umbrella review showed that increasing Hb generally improves physiological and patient-reported outcomes, particularly at lower baseline Hb levels, although the available evidence is heterogeneous and often of limited quality. The thesis further demonstrates that remote monitoring with wearable devices is feasible and can continuously measure parameters such as heart rate and activity. These measurements revealed that red blood cell transfusion is associated with a reduction in heart rate, suggesting decreased cardiovascular compensation after Hb increases. Cognitive and quality-of-life effects were less consistent.

Overall, the findings support moving beyond fixed Hb thresholds towards individualized transfusion strategies that combine haemoglobin measurements with objective physiological data and patient-reported outcomes. Larger clinical trials are needed to determine whether biosensor-guided transfusion decisions can improve quality of life, reduce unnecessary transfusions, and optimize long-term patient care.