Blood Transfusions And Cancer Patients

by Jane Ashley

We, as cancer patients and survivors, learn something new almost every day. Many of us don’t realize that cancer patients may need blood transfusions during treatment. You may be wondering, “Why?”

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Why do cancer patients need blood transfusions?

There are several reasons that patients with cancer may need one or more blood transfusions.

• Anemia. Anemia can be a symptom of blood cancer. Blood cancers like leukemia and lymphoma may crowd out healthy blood-producing cells. Cancer in the spleen or kidney can also cause anemia. Myelodysplastic syndromes (MDS) cause bone marrow failure so that not enough red cells are produced. Anemia can also be caused by strong chemotherapy or radiation.
• Surgery. Some patients lose a considerable amount of blood and need one or more units of blood to replace that blood loss. Surgery patients might just receive red blood cells.
• Low antibody counts. Plasma is sometimes given to patients who have extremely low antibody counts. Antibodies fight infections. Other cancer patients may have bleeding issues and receive plasma to help their blood clot.
• Low platelet counts. Other cancer patients may suffer extremely low platelet counts. Platelets are fragments of cells that help our blood clot. If a patient’s platelet counts drop extremely low, platelets are given to prevent bleeding that could be dangerous. Platelets may be given before surgery to prevent excessive blood loss.
• Declining immune function. A blood cancer patient, even after treatment, might experience a serious decline in immune function. For example, a leukemia patient could contract shingles after treatment and need infusions of gamma globulin to restore their levels of immunoglobulins.

How extensive is the use of blood transfusions in the treatment of cancer?

Blood transfusions are an integral part of blood cancer treatments. Roughly 15 percent of the 14+ million units of blood collected annually in the U.S. are utilized for hematology and oncology patients.

Blood Type

Patients who undergo a stem cell transplant first receive massive chemotherapy to control their cancer disease level; afterward, they receive blood transfusions to replenish their red cells, white cells, and platelets.

Strong chemotherapy causes low blood cell counts. Blood transfusions relieve the fatigue and shortness of breath caused by anemia. Infusions of blood components (plasma and/or albumin) help restore liver functions in patients whose livers are malfunctioning because of blood cancer.

Are blood transfusions safe?

Every pint of donated blood is tested for blood group (O, A, B, or AB) and Rh type. It is also screened for many infectious diseases, including Hepatitis B, Hepatitis C, HIV, syphilis, Zika, and West Nile. Donated blood is also tested for regional infectious disease agents.

Patients are closely monitored during infusion to prevent adverse reactions. The infusions are given slowly, and patients’ blood pressure, temperature, and heart rate are checked frequently. A few patients experience flu-like symptoms relieved by Tylenol. Severe adverse reactions are infrequent. The FDA reported that there were 44 deaths in patients treated with a blood transfusion in 2017.

Extra precautions are taken by irradiating blood before the infusion to prevent adverse reactions in patients at risk.

What is irradiated blood?

Irradiated blood is treated with gamma rays or the x-ray irradiator to prevent Transfusion Associated Graft-versus-Host Disease (TA-GvHD). The radiation inactivates the lymphocytes in the blood to prevent TA-GvHD.

Irradiatied Blood Card

Lymphocytes are part of our immune system. In susceptible patients, a non-radiated blood transfusion can trigger a severe adverse reaction, sometimes leading to death. Non-irradiated blood can cause the lymphocytes to attack healthy cells.

Which cancer patients need irradiated blood?

TA-GvHD is an uncommon, but serious complication that can occur after a blood transfusion in people who have certain medical conditions:

• Patients who have received a stem-cell transplant
• Certain patients who are undergoing strong chemotherapy
• Hodgkin’s lymphoma patients
• Patients who have been treated with fludarabine, cladribine, pentostatin, bendamustine or alemtuzumab

We May Need Blood

Patients who need to receive irradiated blood transfusions receive an identification card to carry in their wallet in the event of an emergency.

What can we do to ensure a readily available supply of blood?

Many cancer patients are eligible to donate blood. Blood cancer survivors are not eligible to donate blood. However, successfully treated patients who have not had a recurrence within 12-months are eligible to donate blood.

Talk to your friends, relatives, and coworkers about the importance of donating blood. With all of us working together, we can help ensure that there is always an adequate supply of blood when someone experiences a medical emergency.

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