Leukemia is a cancer originating in the body’s blood-forming tissues, primarily the bone marrow. This disease disrupts the production of healthy blood components, often leading to deficiencies in red cells, white cells, and platelets. Supportive care with blood transfusions is a frequent part of managing leukemia. Transfusions do not treat the cancer itself, but they provide the necessary healthy cells to function while treatment progresses. Most leukemia patients require blood product transfusions throughout their care to manage symptoms and prevent complications.
Why Leukemia Treatment Requires Blood Support
The need for transfusions arises from two simultaneous challenges: the disease and its intensive treatment. Leukemia cells rapidly accumulate in the bone marrow, the body’s primary blood cell factory. This unchecked growth crowds out and suppresses the healthy stem cells that mature into functional red blood cells, white blood cells, and platelets.
This suppression of normal blood cell production leads to pancytopenia, where counts of all three major blood cell lines are low. Low red blood cell counts cause anemia, resulting in profound fatigue and weakness. A deficiency in platelets, known as thrombocytopenia, increases the risk of excessive bleeding and bruising.
Furthermore, the powerful chemotherapy used to destroy cancer cells also damages the rapidly dividing healthy cells in the bone marrow. This intentional bone marrow suppression, or myelosuppression, is a temporary but expected side effect of treatment. The resulting drop in blood counts is often most severe one to two weeks after chemotherapy, a period known as the nadir.
During this time, the body is highly vulnerable to complications like severe anemia and uncontrolled bleeding. Blood products help patients survive the temporary impact of their therapy while the bone marrow recovers. These transfusions maintain oxygen delivery and clotting ability until the patient’s own blood-forming system can resume normal function.
Differentiating Red Blood Cell and Platelet Transfusions
The two most common blood components transfused for leukemia patients are red blood cells (RBCs) and platelets. RBCs contain hemoglobin, the protein responsible for transporting oxygen to all tissues and organs. Packed RBC transfusions are used to correct anemia, which is characterized by a low hemoglobin level.
Receiving an RBC transfusion helps alleviate symptoms such as severe shortness of breath, dizziness, and extreme fatigue. Doctors monitor the hemoglobin level closely and transfuse when the count drops below a threshold or if the patient is symptomatic. A single unit of packed red blood cells takes between two to four hours to infuse.
Platelet transfusions are administered to manage thrombocytopenia, the low platelet count that impairs clotting ability. Platelets are small cell fragments that adhere to the site of an injury to stop bleeding. Without sufficient platelets, patients face risks ranging from easy bruising to life-threatening internal hemorrhage.
These transfusions are given when the platelet count falls below a specified level or before an invasive procedure to prevent excessive bleeding. While RBC transfusions require matching the major blood type (A, B, AB, O), platelets do not always require a perfect blood type match. Platelets are often infused more quickly than red cells, usually over 30 to 60 minutes.
The Process of Receiving a Blood Transfusion
Before administration, a rigorous safety process ensures the donated blood is compatible with the recipient. The patient’s blood must first be typed to determine their specific ABO and Rh status. This is followed by a cross-match test, which mixes the patient’s blood with the donor product to confirm there is no adverse reaction.
The transfusion is delivered intravenously, often through a vein in the arm or via a central line already in place. The blood product bag is connected to an IV pump which controls the rate of flow into the patient’s bloodstream. The entire process requires careful monitoring by medical staff.
A nurse checks the patient’s temperature, heart rate, and blood pressure before the transfusion starts and at regular intervals afterward. This close observation is necessary to identify any signs of an acute transfusion reaction, a rare but serious complication. Symptoms like fever, chills, hives, or shortness of breath can indicate a reaction and require the immediate cessation of the infusion.