REFLECTIONS ON MULTIPLE STRATEGIES TO REDUCE TRANSFUSION IN CANCER PATIENTS: A Joint Narrative

Abstract Transfusion of red blood cells, platelets and plasma is widely used in the management of anemia and coagulopathy in cancer patients undergoing surgery, chemotherapy, and radiation. The decision to transfuse should not be made lightly as exposure to transfused blood, whether from an allogene...

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Bibliographic Details
Published in:Transfusion and apheresis science 2017-06, Vol.56 (3), p.322-329
Main Authors: Goubran, Hadi, Seghatchian, Jerard, Prokopchuk-Gauk, Oksana, Radosevic, Julia, Sabry, Waleed, Iqbal, Nayyer, Burnouf, Thierry
Format: Article
Language:English
Subjects:
Alternatives
Blood Transfusion - methods
Cancer
Health technology assessment
Hematology, Oncology and Palliative Medicine
Humans
Neoplasms - therapy
Reduction
Transfusion
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Summary:Abstract Transfusion of red blood cells, platelets and plasma is widely used in the management of anemia and coagulopathy in cancer patients undergoing surgery, chemotherapy, and radiation. The decision to transfuse should not be made lightly as exposure to transfused blood, whether from an allogeneic or even autologous source, is not without risk and the long-term effect of blood transfusion on cancer outcomes remains questionable. Recognition of anemia associated with nutritional deficiency should be promptly corrected while avoiding the use of erythropoiesis stimulating agents. Minimizing blood loss and the prompt control of bleeding, coupled with a restrictive transfusion strategy, seem to be a reasonable approach that does not appear to be associated with long-term sequelae. Limiting platelet transfusion to patients with severe hypo-proliferative thrombocytopenia, and implementation of local hemostatic measures, together with the use of fractionated coagulation factor concentrates, as an alternative to frozen plasma transfusion, may reduce the exposure of cancer patients to potentially harmful thrombogenic and pro-inflammatory cellular microparticles. This joint narrative highlights current opinions for minimising blood usage in patients with cancer.
ISSN:1473-0502
1878-1683
DOI:10.1016/j.transci.2017.05.018