Why do leukemia patients need blood transfusions?

Blood transfusions are sometimes part of a leukemia treatment plan. They don’t treat cancer, but they can help reduce some cancer symptoms. They are used to treat low blood counts and help prevent infections, bleeding, bruising and anemia.

A transfusion supplies your body with more blood through an intravenous (IV) line. The whole process usually takes several hours. Not everyone with leukemia will need blood transfusions. But they can make a difference for people with leukemia that causes a low number of red blood cells, white blood cells, or platelets.

Leukemia is a cancer of the blood. Blood cancer UK says it affects how your body makes blood cells. There are several types of leukemia, and most types primarily affect your body’s white blood cells. White blood cells are the cells your body uses to fight infections.

Most forms of leukemia cause a large amount of cancerous white blood cells to grow. This crowds out healthy white blood cells and prevents your immune system from fully functioning. As leukemia progresses, cancerous white blood cells can also overwhelm your red blood cells and platelets. Too few red blood cells can lead to anemia and too few platelets can make blood clotting difficult.

You may also develop anemia as a result of leukemia treatments. Radiation therapy and chemotherapy are used to kill cancer cells. Treatments can also prevent your body from making new healthy blood cells.

Additionally, cancer treatments can make it difficult to eat the foods you need to get enough iron from your diet. A diet that is too low in iron can lead to anemia and fatigue.

A blood transfusion does not treat leukemia itself or fight cancer. Corn it treats symptoms caused by the effects of leukemia on your blood.

The transfusion you will receive will be blood components taken from donated blood. Donated blood was filtered and separated. So, instead of receiving whole blood, you will only receive the component that is most useful to you.

For example, if you have anemia, you will only receive red blood cells. If you have low platelets, you can simply receive platelets.

Other components you may receive include:

Types of blood transfusions used to treat leukemia

A few types of blood cell transfusions are commonly used to treat leukemia. According to the Leukemia & Lymphoma Society, they include:

  • Red blood cell transfusions. These transfusions can treat anemia. They are prescribed for people with leukemia who have low red blood cell counts and are beginning to experience symptoms of anemia.
  • Platelet transfusions. Doctors prescribe platelet transfusions for people with leukemia who have low platelet counts. They can treat and reduce the risk of excessive bleeding and bruising.
  • Plasma and cryoprecipitate transfusions. These are sometimes ordered for people who have low levels of proteins that help their blood clot. It usually occurs as a result of liver disease and is less common in leukemia. However, it can occur in people with promyelocytic leukemia.
  • Gamma globulin transfusions. Gamma globulins are blood plasma proteins that help prevent infections. People with chronic lymphocytic leukemia often have low levels of gamma globulin and need a transfusion to replenish their blood.
  • Albumin transfusion. These transfusions are less frequent. People who have liver problems or whose leukemia has affected their liver may need an infusion of this blood protein.
  • Granulocyte transfusions. Doctors sometimes prescribe them for people with low white blood cell counts to reduce the risk of infection. They are rarely performed and are not part of routine care for leukemia. This is due to difficulties in collection, processing, administration and potential adverse effects. Granulocytes are a type of white blood cells.

There is no standard or fixed amount of transfusions that people with leukemia need. Some people with leukemia may never need blood transfusions. Others might need it as often as several times a month.

It is more common for people with advanced leukemia to receive frequent transfusions. But even at this stage, this does not apply to everyone.

Blood transfusions are generally considered safe. Most people receive transfusions without any reaction. However, as with any medical procedure, there are some possible risks. Some reactions are immediate and will occur during or just after transfusions. Other possible reactions will only occur weeks or even months later.

Immediate side effects include:

Fever is the most common side effect of transfusion. Tell medical personnel immediately if you experience any of these side effects. If necessary, they can make changes such as stopping the transfusion early.

Reactions that may develop weeks or months later include:

  • Transmission of viral infections. There is a slight risk of contracting a viral illness from a blood transfusion. However, developments in blood testing have greatly reduced this risk in recent decades.
  • Transmission of cytomegalovirus (CMV). CMV can cause pneumonia and other complications in people undergoing stem cell transplants. Doctors are especially cautious about the risk of CMV transmission in people who have received a blood transfusion and will undergo a stem cell transplant.
  • Transmission of bacterial infections. It is rare to get a bacterial infection from a red blood cell transfusion, but it is possible. However, precautions are taken in blood establishments to ensure that this risk remains very low.
  • Alloimmunization. Alloimmunization occurs when your immune system makes antigens against transfused blood. It does not always cause symptoms, but it may increase the likelihood of side effects from future blood transfusions.
  • Graft versus host disease (GVHD). GVHD is a very rare reaction that can occur after a white blood cell transfusion. In GVHD, donor white blood cells attack your body’s skin, bone marrow, liver, and intestines, leading to serious complications.

According to the Canadian Cancer Society, there are very few steps you can take to prepare for an elective blood transfusion. You can continue with your usual diet and daily activities before your blood transfusion. Most blood transfusions are done in an outpatient clinic. Before your transfusion, it is a good idea to:

  • Ask your doctor how long the transfusion will take. Most transfusions take between 1 and 4 hours.
  • Stay well hydrated.
  • Bring a book or laptop to keep you busy during the transfusion. You will usually be able to work, read, eat, or drink after the first 15 minutes or so of the transfusion as long as it does not interfere with the IV line.
  • Pack a bottle of water and a light snack.
  • Pack a blanket, hoodie or sweater.

Blood transfusions can be part of the treatment for leukemia. They don’t fight cancer, but they can help treat low blood counts caused by leukemia and leukemia treatments.

Blood transfusions may be ordered if you have anemia, low platelet count, or low white blood cell count. Not everyone with leukemia will need blood transfusions. Blood transfusions are generally considered safe and serious reactions are rare thanks to improvements in blood testing over the past 20 years.

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