Transfusion of patients undergoing bone marrow transplantation

Bone marrow transplant recipients require intensive transfusion support preceding the marrow infusion, because of their underlying disease or the chemotherapeutic agents administered, and for 14 days or more post-transplantation until engraftment has occurred and marrow function has returned. Red blood cells, plasma, and platelets are the usual components transfused; granulocyte concentrates are occasionally required. Marrow transplantation across ABO and Rh barriers is performed routinely and requires careful, knowledgeable attention to the blood group of components chosen throughout the transplantation process to ensure effective transfusion support. This paper is a review of the general principles governing pre- and post-transplantation transfusion support, potential indications for the transfusion of various blood components in the marrow transplant setting, and the recommended blood groups of these components when ABO incompatibilities exist.