Transfusion of the patient with acquired immunodeficiency syndrome

Cytopenias are commonly found in patients infected with human immunodeficiency virus. Thrombocytopenia due to peripheral destruction of platelets is an early manifestation, normocytic anemia and neutropenia are late manifestations. Transfusions are required when symptoms become severe. Chemotherapy of patients with the acquired immunodeficiency syndrome (AIDS) is also cytotoxic and further contributes to the transfusion requirement. Patients with AIDS receiving treatment with zidovudine, in particular, have a high transfusion requirement. Empirically, many centers irradiate blood products transfused to AIDS patients to prevent possible graft-vs-host reaction in the immunologically compromised recipient. Attempts to correct the deficiency of helper T cells with lymphocyte transfusion and marrow transplantation have so far been ineffective. Similarly, therapeutic trials to treat this disease by apheresis of virus-bearing cells has been ineffective and has, therefore, been abandoned.