Blood and Blood Product Transfusions for Cancer
A blood transfusion is when blood or parts of the blood are given to a person through an IV line placed in a vein. The blood and blood parts used for transfusion are called blood products. The blood usually comes from another person (donor). This sheet tells you more about how blood and blood products may be used to help treat cancer.
Understanding blood and blood parts
Blood is a fluid that flows throughout the body. It is made up of different parts that perform specific roles.
Red blood cells (RBCs) carry oxygen throughout the body.
White blood cells (WBCs) are part of the body’s immune system. Their main job is to help fight infections and diseases.
Platelets are fragments of blood cells that help with clotting. When you have a cut or bruise, platelets come together to form a clot or “plug.” This helps to control bleeding, so you don’t lose too much blood.
Plasma is the liquid portion of blood. It carries the different types of blood cells to all the parts of the body. Plasma also carries proteins called clotting factors. Clotting factors help platelets with the clotting process.
Blood is divided into four types: A, B, AB, and O. Blood also has Rh types: positive (+) and negative (–). Any blood products you receive during a transfusion must be compatible with your blood type.
Why a transfusion may be done
Cancer can cause various problems that may need treatment with transfusions. For example:
Cancer can affect the bone marrow. This is the soft, spongy part inside bones where most of the body’s blood cells are made. When the bone marrow is damaged or destroyed, the body cannot make enough blood cells. Without enough blood cells, the body cannot maintain its normal functions.
Cancer can cause anemia. This condition happens when there are too few red blood cells in the body. Without enough red blood cells, the body’s tissues and organs do not receive enough oxygen. Anemia can make you feel tired or short of breath.
Occasionally, certain cancers can cause internal bleeding. This can lead to blood loss that can threaten your health.
Certain treatments for cancer can lower the number of healthy blood cells in the body and need the use of transfusions. These treatments include:
Chemotherapy (chemo) uses strong medicines to help kill cancer cells. However, these medicines can also damage healthy cells, including cells in the bone marrow. This can lower your blood cell counts.
Radiation uses high-energy X-rays to help kill cancer cells. As with chemo, this treatment can also damage healthy cells in the bone marrow. This can lower your blood cell counts.
Surgery may be needed to remove a tumor (group of cancerous cells) in the body. The surgery can cause blood loss that needs the use of transfusions.
Types of transfusions
Depending on your needs, your healthcare provider may recommend one or more of the blood products listed below as part of your treatment plan. Your healthcare provider will explain to you how the transfusions will be given and how often they may be needed. Before receiving any blood products, you will need to have some blood drawn so your blood type can be determined. You will also need to sign a consent form acknowledging the potential risks of receiving a transfusion.
These are most often used to treat severe anemia or blood loss. RBCs must be “typed” to match your blood type. Except in severe blood loss, cancer patients receive “packed” red blood cells without plasma. Each bag (called a “unit”) takes about 2 hours to infuse. During that time, nursing staff will be monitoring your temperature, pulse and blood pressure.
These are used if your platelet count is too low, which puts you at high risk of bleeding. Although platelets should be “typed” to match your blood type, it is not needed. Platelets can be obtained in different ways:
From one donor (“apheresis product”)
Combined from several bags of whole blood (“pooled product”)
From a community donor who is specially matched (“matched product”)
A bag of platelets takes about 1 hour or less to infuse. As with RBCs, nurses will monitor your temperature, pulse, and blood pressure.
Plasma (FFP) transfusions
These may be used to supply the blood with more clotting factors to help stop excess bleeding. FFP must be “typed” to match your blood type. One unit of plasma is taken from a unit of whole blood and is then frozen at the blood bank. Plasma is thawed when it is needed. FFP usually takes 1 to 2 hours to infuse.
Due to the severe risks involved, these transfusions are rarely used. If there is a problem with the WBCs, your healthcare provider may recommend other treatments to help promote the growth of new WBCs.
Risks and possible complications of blood and blood product transfusions
These include the following:
Fever and chills
Allergic reaction (itchy skin or rash; redness, or flushing of the face)
Low blood pressure
In the rare event of receiving the wrong ABO blood type:
Fast heart rate
Low blood pressure
Although extremely rare, some diseases can be transmitted through blood transfusions. They include:
Learning more about the safety of blood donation and blood transfusions
Strict measures are taken to make sure that donated blood and blood products are safe before they are given to you. To learn more about where donated blood comes from and the process of screening blood, these websites may help:
American Cancer Society, Blood Donation and Transfusion, www.cancer.org/Treatment/TreatmentsandSideEffects/TreatmentTypes/BloodProductDonationandTransfusion/index
American Red Cross, Learn About Blood, www.redcrossblood.org/learn-about-blood
April 15, 2017
Fetterman, Anne, RN, BSN,Gersten, Todd, MD,Image reviewed by StayWell medical illustration team.