Leukemia is a cancer affecting blood-producing cells in the bone marrow. This disruption leads to abnormal blood cell production, often white blood cells, which crowd out healthy cells. While leukemia treatment is multifaceted, blood transfusions commonly serve as supportive measures to manage disease effects and therapy side effects. This article explores why transfusions are necessary and what to expect.
Why Transfusions Become Necessary
Leukemia and its treatments, particularly chemotherapy, significantly impair the bone marrow’s ability to produce healthy blood cells. Cancerous cells overcrowd the bone marrow, reducing space for normal red blood cells, white blood cells, and platelets. Chemotherapy drugs, designed to target rapidly dividing cells, also suppress the production of fast-growing healthy blood cells.
Anemia, a low red blood cell count, is a common consequence. Red blood cells contain hemoglobin, responsible for carrying oxygen throughout the body. Low levels cause symptoms such as fatigue, weakness, shortness of breath, dizziness, headaches, and pale skin.
Thrombocytopenia, a low platelet count, is another frequent deficiency. Platelets are small cell fragments essential for blood clotting. A shortage can lead to easy bruising, tiny red or purple spots (petechiae), frequent nosebleeds, bleeding gums, heavy menstrual periods, and a risk of more severe internal bleeding.
Specific Blood Components Used
To address these deficiencies, specific blood components are transfused rather than whole blood. The choice depends on the patient’s individual needs, determined by their latest blood cell counts and symptoms. Red blood cell and platelet transfusions are the most common types for leukemia patients.
Red blood cell transfusions combat anemia and improve the body’s capacity to deliver oxygen to tissues. Each unit of packed red blood cells (typically 300 milliliters) can raise hemoglobin levels by about 1 gram per deciliter in an average adult. This alleviates symptoms like fatigue and shortness of breath, improving overall well-being.
Platelet transfusions prevent or stop bleeding in patients with low platelet counts. Maintaining a count above 5,000 to 10,000 per microliter helps reduce the risk of minor and more significant bleeding events. Platelets can be separated from a single donor or concentrated from multiple donors, and are filtered to remove white blood cells to prevent certain reactions. While red blood cells and platelets are the primary focus, fresh frozen plasma (containing clotting factors) may be used for specific clotting factor deficiencies.
What to Expect During a Transfusion
Receiving a blood transfusion is a routine procedure performed in a healthcare setting. Before the transfusion, healthcare professionals verify the patient’s identity and blood type against the donated product to ensure a precise match and prevent adverse reactions.
The blood product is administered intravenously, typically into an arm vein through an IV line. Infusion duration varies by component. A unit of red blood cells usually takes 2 to 4 hours, though it can be administered faster in emergencies. Platelet transfusions generally take less time, often 30 to 60 minutes per unit.
Throughout the transfusion, healthcare staff closely monitor the patient’s vital signs (temperature, blood pressure, heart rate) and observe for reactions. While most transfusions proceed without issues, mild reactions like fever, chills, or a skin rash can occur. These are typically managed with medication, or by slowing or temporarily stopping the infusion.
Key Questions About Transfusions
The necessity of blood transfusions for leukemia patients varies significantly, depending on the specific type of leukemia, its stage, treatments, and individual response. While common, not all patients require them, though many do at some point during their care.
The frequency of transfusions also differs greatly. Some patients might require multiple transfusions per week, particularly during intensive chemotherapy, while others may only need them once a month or less. This variability underscores the individualized nature of leukemia treatment and supportive care.
Blood transfusions are a form of supportive care and do not cure leukemia. They manage symptoms like fatigue and bleeding, alleviate treatment side effects, and improve quality of life by replenishing essential blood components. Transfusions address the consequences of the disease and its therapy, not the cancer itself.
While blood transfusions are generally considered safe, there are potential risks. Serious reactions are rare due to rigorous screening processes for donated blood. Risks include allergic reactions, fever, chills, fluid overload, or in very rare cases, more severe complications like a hemolytic transfusion reaction or graft-versus-host disease. Donated blood undergoes extensive testing for infectious diseases, making the risk of viral transmission very low.