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Blood Transfusion during Cancer Treatment: What to Expect?

Blood transfusion can be an essential part of the cancer treatment, where it may be required to mitigate effects of cancer or side effects of cancer therapy. It is not perse a cancer treatment, and it is not required for all patients. Blood transfusion aids in the management of the adverse effects of cancer therapy and improves the overall quality of life.

This article attempts to answer the most frequently asked questions about blood transfusions related to cancer treatment.

1. What is a blood transfusion?

   Blood transfusion is a medical procedure in which a blood or blood component donated by a healthy individual is given to replace it in people who need it.

2. When is blood transfusion required in cancer patients?
   

   Here are some reasons that could prompt the need for a blood transfusion in cancer patients:

   • Blood loss due to surgery: Complex cancer operations can result in significant blood loss. In such circumstances, a blood transfusion is required to return the blood to normal levels.
   • Chemotherapy-induced anemia: Chemotherapy suppresses the red blood cell production in bone marrow. Reduction in number of red blood cells leads to a condition called anemia. Blood transfusions can help replace red blood cell counts and alleviate symptoms such as weariness and weakness that are caused due to low blood cell counts.
   • Bone marrow failure: Certain blood cancers like leukemia and myeloma predominantly affect bone marrow. This interferes with the production of normal blood cells and their functions. Blood transfusions serve to replenish the blood cell count and restore its functionality.
   • Low platelet count: Chemotherapy lowers the number of platelets in the body, which are necessary in the clotting of blood. Platelet transfusion can prevent bleeding episodes in such cases.
   • Bone marrow transplant: Bone marrow transplantation is a cancer treatment in which diseased bone marrow is replaced with healthy bone marrow. This treatment is typically preceded by a large dosage of chemotherapy and radiation therapy, which change the function of the bone marrow. Blood transfusions are required at this time until the new bone marrow can function normally.
3. What are the types of blood transfusion?
   

   Blood is made up of various components like liquid plasma, red blood cells, white blood cells and platelets. Transfusion can be of whole blood or one of its components depending on the medical condition.

   • Plasma transfusion: This is required in patients where there is increased risk of bleeding to replenish the clotting factors in the body.
   • Red blood cell transfusion: Red blood cell transfusion is given when red blood cell or hemoglobin levels reduce causing fatigue, dizziness, or shortness of breath. this is very useful to maintain hemoglobin levels in patients undergoing complex surgeries or receiving high dose chemotherapy.
   • Platelet transfusion: Platelet transfusion is required when bone marrow function is compromised during cancer or cancer therapy, increasing the risk of spontaneous bleeding.
   • White blood cell transfusion: WBC transfusions are called granulocyte transfusions, however there are very limited use for them specially used in treatments i=of acute leukemias, however there are specific injections call granulocyte (WBC) growth factors which may be given to stimulate WBC counts during chemotherapy (as chemotherapy can reduce immunity by suppressing white blood cell counts)


4. Are there any tests patients should undergo before blood transfusion?
   

   Before transfusion, the donor has to undergo certain tests to match the blood type and check compatibility. A few common blood tests that need to be done are blood typing, antibody screening, and cross-matching.

5. How much time does the process of transfusion take?
   

   Red blood cell transfusions take 2 to 3 hours, while platelet transfusions take as little as half an hour.

6. What should be expected during a blood transfusion?
   

   Blood products come in specialised storage bags and are usually cold, initially the are brought to room temperature followed by transfusion. pre-transfusion patient is given anti allergic medicines and sometimes diuretics to avoid side effects during and post transfusions. blood product transfusions are usually given through the intravenous route where in a intravenous line is secured in the forearm or hand or while admitted a central line catheter may be used. In most cases, there is no discomfort while the blood is injected.

7. Are there any possible side effects of blood transfusion?
   

   Blood transfusion is a typically safe procedure, with benefits outweighing concerns. Some uncommon adverse effects of blood transfusion include fever, chills, headache, nausea, and allergic responses, as well as a hemolytic reaction that can cause kidney damage, transfusion-related lung injury, circulatory overload, iron overload, and infectious disease. Your healthcare team will keep a close eye on the adverse effects listed above.
   Consult your oncologist to determine if you require a blood transfusion. Know everything about the procedure. Complete any prerequisite tests that are required. Learn about its adverse effects and how to manage them.

Dr. Udip Maheshwari
MD DNB ECMO
Consultant Cancer Physician
MOC Cancer Care & Research Centre Ghatkoper.