Toward Personalized Transfusion Strategies: The Emerging Role of Wearable Biosensors in Chronic Anemia Management

Chronic transfusion-dependent anemia presents ongoing challenges in optimizing symptom control and functional outcomes, particularly in an older, often comorbid patient group. Conventional transfusion strategies based on fixed hemoglobin thresholds may inadequately address the individual variability in oxygen delivery needs and symptom burden. Wearable biosensor technologies enable continuous monitoring of physiological parameters such as heart rate, respiratory rate, and physical activity in real-world settings. These tools offer the potential to detect early deterioration and support more responsive, patient-centered transfusion decisions and improve hemovigilance. This review evaluates current evidence on the feasibility, acceptability, and clinical relevance of biosensor use in transfusion medicine. Findings from recent pilot studies demonstrate high data quality, favorable tolerability, and preliminary indications of physiological response following transfusion. However, the clinical utility of biosensor-guided transfusion strategies remains unproven, with key challenges including data interpretation, workflow integration, and validation of clinically meaningful endpoints. As the field moves toward personalized supportive care, biosensors may offer a novel means to optimize transfusion timing, preserve functional capacity, and enhance quality of life.