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Transfusion issues in cancer patients.
Augusto B Federici1, Chiara Vanelli, Luisa Arrigoni
1Hematology and Transfusion Medicine, L. Sacco University Hospital and Department of Internal Medicine, University of Milan, Milan, Italy. augusto.federici@unimi.it
Thrombosis Research
|June 12, 2012
Summary
Allogeneic blood transfusion (ABT) is vital for cancer patients but carries risks like TA-GVHD. Modifications like leukocyte reduction and irradiation, along with new advances, improve transfusion safety for these vulnerable individuals.
Area of Science:
- Oncology
- Transfusion Medicine
- Hematology
Background:
- Allogeneic blood transfusion (ABT) is a critical supportive therapy for cancer patients, providing packed red blood cells (PRBC), platelet concentrates (PC), and fresh frozen plasma (FFP).
- Cancer patients receiving ABT are susceptible to various complications, including transfusion-associated graft versus host disease (TA-GVHD), transfusion-transmitted infections, alloimmunization, pulmonary issues, and immunomodulation.
- Hematopoietic progenitor cell (HPC) transplantation recipients present unique transfusion challenges, such as ABO incompatibility and risks from the infusion process itself (e.g., DMSO toxicity, hemolytic reactions).
Purpose of the Study:
- To highlight the significant role of ABT in cancer care.
- To outline the potential complications and adverse reactions associated with ABT in cancer patients.
- To discuss necessary modifications and emerging technologies for enhancing transfusion safety in this population.
Main Methods:
- Review of current transfusion practices in oncology.
- Analysis of complications associated with PRBC, PC, and FFP transfusions in cancer patients.
- Evaluation of risk-reduction strategies including leukocyte-reduction, irradiation, and pathogen inactivation.
Main Results:
- ABT components are essential but can lead to serious adverse events in cancer patients.
- Specific interventions like leukocyte reduction and irradiation are recommended to mitigate risks.
- Advanced strategies such as pathogen inactivation and synthetic alternatives show promise for future transfusion safety.
Conclusions:
- Transfusion therapy in cancer patients requires careful component selection and risk mitigation strategies.
- Leukocyte reduction and irradiation are crucial for reducing transfusion-related complications.
- Ongoing research into novel approaches like pathogen inactivation will further improve the safety and tolerance of blood transfusions for cancer patients.
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