Use of blood and blood products for supportive care in cancer treatment

Prophylactic platelet transfusion can prevent spontaneous hemorrhage in thrombocytopenic cancer patients undergoing intensive treatment, but it is limited by the development of platelet alloimmunization. Exclusive use of leukocyte-depleted blood products delays or prevents the development of platelet alloimmunization and also decreases the frequency of chill and fever reactions and reduces the transmission of cytomegalovirus and possibly other viral infections. Management of disease refractory to platelet transfusion remains a difficult problem. Intravenous immune globulin reduces the incidence of infection and may modify the severity of gram-negative sepsis, decreases the incidence of acute graft-versus-host disease, and may benefit some patients with platelet refractoriness. All blood products given to severely immunocompromised patients, including those undergoing chemoradiotherapy and high-dose therapies, should be irradiated. In addition, designated donor transfusions from first-degree relatives (even when given to immunocompetent patients) should be irradiated.