Reasons for Needing a Blood Transfusion


You might need a blood transfusion because of the effects of your cancer or because of the effects of certain cancer treatments.

If your cancer is causing the following, you might need a blood transfusion:

  • Internal bleeding - Certain cancers, especially those of the digestive system (for example, cancers of the colon, pancreas, or esophagus), can cause internal bleeding. This can cause anemia, which means that you don’t have enough red blood cells.
  • Anemia of chronic disease - Cancer and certain chronic diseases can slow the production of red blood cells in the bone marrow. This is known as anemia of chronic disease, which usually gets worse gradually.
  • Not enough blood-making cells - Leukemia and other cancers that start in the blood and bone marrow and cancers (such as breast, lung, and prostate cancer) that start in other parts of the body and then spread to the bone marrow can interfere with the ability of bone marrow to make blood. The cancerous cells can push out healthy cells from the bone marrow or destroy these cells; as a result, the bone marrow can no longer make blood cells. Cancer can also reduce your blood counts by affecting the organs (such as the kidneys and spleen) that help make sure that you have enough blood cells. This can lead to low counts of red blood cells, white blood cells, and platelets.

Different kinds of cancer treatments can also lower your blood counts or cause other effects that can best be treated with a blood transfusion. These treatments include:

  • Chemotherapy - Chemotherapy can kill the healthy stem cells in the bone marrow.  Stem cells are bone marrow cells that develop into blood cells. If this happens, you might have low levels of red blood cells, white blood cells, and platelets.
  • Surgery - If you have major surgery to treat your cancer, you might need a transfusion of red blood cells or platelets to make up for the blood lost during the operation.
  • Radiation - Radiation can affect the bone marrow stem cells that become blood cells, especially if the radiation is used to treat the large bones that contain most of the bone marrow. This can reduce your red blood cell and white blood cell levels.
  • Bone marrow transplant and peripheral blood stem cell transplant - Before you have one of these treatments, you will probably be given a large dose of chemotherapy and/or radiation therapy. These treatments will destroy the bone marrow cells that become blood cells. You will probably have very low blood cell counts after the procedure.

If you are receiving a treatment that could reduce your blood cell counts, your doctor will probably keep track of your blood cell counts. He or she will do this with a complete blood cell count (CBC), which means that the doctor will examine a sample of blood drawn from a vein in your arm.

If the counts of certain blood components are low, your doctor might recommend a transfusion of the components you need. A red blood cell transfusion can prevent or treat the complications of anemia, which include tiredness, weakness, shortness of breath, lightheadedness, and sometimes even heart attack or stroke. A platelet transfusion can reduce the chances of bleeding problems.

However, scientists have not yet developed practical techniques to transfuse white blood cells to prevent infections caused by low white blood cell counts. For this reason and because of the side effects, white blood cell transfusions are rarely used.

This content was last reviewed August 15, 2010 by Dr. Reshma L. Mahtani.
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