Blood Transfusions for Leukemia and Lymphoma Patients

Why Do Leukemia and Lymphoma Patients Need Blood Transfusions?

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Blood transfusions are needed when a person is low in red blood cells or other blood components, such as platelets -- tiny packages of substances that help blood to clot in the case of injury.

These blood cells and blood components may be lower than normal for a variety of different reasons in cancer patients. If you have blood cancer -- such as leukemia, lymphoma or myeloma -- you will likely receive transfusions of blood and blood products during your treatment.

Low Counts Due to the Malignancy

In cancers that affect the bone marrow, normal production of healthy red blood cells, white blood cells, and platelets is often decreased. Your bone marrow is like a factory, producing new blood cells all the time. When a cancer grows in the bone marrow crowding out healthy cells, this results in low cell counts out in the blood stream. In many cases, blood cancer patients have low cell counts before they even begin treatment for their disease.

Low Counts Due to Treatment

Treatments such as chemotherapy and radiation can also cause a decrease in your blood cell counts. Life saving cancer therapies that target rapidly dividing cancer cells often affect healthy cells as well. So, while the therapy is killing the leukemia or lymphoma cells in your marrow, it also suppresses the healthy, blood-forming cells in the bone marrow. Following treatment for your blood cancer, your blood cell counts may be low for several weeks.

Effects of Low Counts

The lack of sufficient healthy red blood cells, or anemia, reduces the body's ability to deliver oxygen to the organs and tissues that need it. The body is wonderful at compensating for anemia up to a point, but sometimes compensation is not a good thing in a cancer patient.  Additionally, low platelet counts, or thrombocytopenia, can make it difficult for your body to stop bleeding once it begins.

Decreased white blood cells counts can increase the risk for infection.

Complications from low platelets and red blood cells can be prevented with an infusion of donated blood, or transfusion. In fact, blood transfusions can be life-saving.

Transfusion

Blood transfusions in North America and most countries are very safe. Donated blood is tested and screened for many infectious diseases before it is given to patients. However, it is not possible at this time to say blood transfusions do not have any risks. Over the years, scientists have come up with new testing techniques to improve detection of viruses in donated blood.

There is also the possibility that you may have a reaction from your blood transfusion. Signs of a transfusion reaction are:

  • Fever, chills
  • Shortness of breath
  • Allergic-type symptoms such as rashes, or itching
  • Pain in the sides or back
  • Pain at the IV infusion site
  • Dark colored or red urine
  • Nausea and vomiting
  • Chest pain

While some transfusion reactions are short lived and easily treated, others can be very serious or life threatening.

For this reason, it is important to let your nurse know if you feel “different” or “weird” during your transfusion, even if it seems silly or you can’t put your finger on what has changed.

Conclusion

As a result of bone marrow invasion of cancer, or of the treatment for that cancer, almost all leukemia, lymphoma, and myeloma patients will need a blood transfusion at some point along their journey. While the risk of contracting a disease from a blood transfusion is slim in most developed countries, blood transfusions are not completely without risk. For instance, repeated transfusions can lead to iron overload -- a treatable condition. In most cases, however, the benefit of receiving a donated blood product outweighs the risk. If you have concerns or questions about blood transfusions in your specific situation, ask your doctor.

Updated March 2016, TI.

Sources

Rohde JM, Dimcheff DE, Blumberg N, et al. Health Care–Associated Infection After Red Blood Cell Transfusion: A Systematic Review and Meta-analysis. JAMA. 2014;311(13):1317-1326.

Gobel, B. Bleeding. In Yarbro,C., Frogge, M., Goodman, M., Groenwald, S. (eds). (2000). Cancer Nursing: Principles and Practice 5th ed. Jones and Barlett: MA. pp. 709-737.

Tonelli M, Hemmelgarn B, Reiman T, et al. Benefits and harms of erythropoiesis-stimulating agents for anemia related to cancer: a meta-analysis. CMAJ: Canadian Medical Association Journal. 2009;180(11):E62-E71.

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