The Role of Transfusion Medicine in Treating Cancer Patients

Jung Kim^*
*Correspondence: Jung Kim, Department of Clinical Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea, Email:

Introduction

Transfusion medicine plays a critical role in the management of cancer patients, providing essential support to patients undergoing treatment, especially those who suffer from complications such as anemia, thrombocytopenia, and coagulopathies. Cancer therapies, including chemotherapy, radiation, and stem cell transplants, can result in bone marrow suppression and the destruction of blood cells, necessitating frequent transfusions to sustain patients’ health. The application of transfusion medicine in oncology is both an art and a science, requiring a deep understanding of hematologic needs, blood product management, and the physiological challenges faced by cancer patients. This treatment modality not only supports cancer therapy by managing side effects but also contributes to improving the quality of life for those undergoing aggressive treatments [1].

One of the most immediate concerns for cancer patients is anemia, a common condition caused by both the cancer itself and the treatment regimens. Anemia arises when there is a deficiency of red blood cells or hemoglobin, which is responsible for transporting oxygen throughout the body. Chemotherapy and radiation therapies, although effective at targeting and destroying rapidly dividing cancer cells, also affect the bone marrow, which is where blood cells are produced. This suppression of bone marrow function can lead to reduced production of red blood cells, leading to fatigue, weakness, and other symptoms associated with anemia.

Description

Blood transfusions, particularly of red blood cells, are often required to manage severe anemia, helping to restore hemoglobin levels and provide symptomatic relief to patients. By improving oxygen delivery to tissues and organs, red blood cell transfusions can reduce the fatigue and weakness that frequently plague cancer patients, allowing them to better tolerate treatment and maintain a more active lifestyle. Alongside anemia, thrombocytopenia, a condition in which a patient has low platelet counts, is another common issue in cancer patients. Platelets are essential for blood clotting and wound healing, and their depletion can make even minor injuries dangerous. Chemotherapy and radiation therapy can significantly affect platelet production by damaging the bone marrow, which compromises the body’s ability to control bleeding. Transfusion medicine steps in to manage this condition by providing platelet transfusions. These transfusions can rapidly restore platelet counts and reduce the risk of bleeding, which is a serious concern for patients undergoing cancer treatments. Regular platelet transfusions may be necessary for patients with chronic thrombocytopenia, enabling them to undergo additional treatments without the added complication of bleeding risks [2].

Cancer patients are also at risk of developing coagulopathies, conditions that affect the blood’s ability to clot, leading to either excessive bleeding or clot formation. Some cancers, particularly those that involve the liver or gastrointestinal tract, can directly impact the body’s ability to produce clotting factors, which are proteins necessary for blood coagulation. Additionally, chemotherapy and radiation can contribute to both excessive bleeding and the formation of blood clots. Blood product transfusions, including Fresh Frozen Plasma (FFP) or clotting factor concentrates, are integral to managing these conditions. FFP contains clotting factors and is frequently transfused in patients with bleeding disorders or those who need support during surgery or invasive procedures. In patients with severe coagulopathy, the transfusion of specific clotting factors may be required, depending on the type of factor deficiency they are experiencing [3].

While transfusion medicine is invaluable in treating the blood-related complications of cancer, the practice has evolved significantly in recent years to become more patient-centered. The transfusion of blood products is no longer seen as a one-size-fits-all approach. Instead, physicians and hematologists are more mindful of the timing, type, and dose of blood products required for each individual patient. Advances in laboratory techniques and diagnostics have allowed healthcare providers to more accurately determine the specific needs of cancer patients, thereby minimizing unnecessary transfusions and reducing the risks associated with blood product administration. Blood transfusions, while lifesaving, come with certain risks, including allergic reactions, febrile reactions, and the potential for transmission of infectious diseases. By fine-tuning blood management strategies, clinicians can better match transfusion therapy to the patient’s individual clinical situation, ultimately improving patient outcomes [4].

The management of cancer patients through transfusion medicine is not confined to blood product administration alone. It also extends to other specialized treatments, such as Hematopoietic Stem Cell Transplantation (HSCT). HSCT is used to treat various cancers, including leukemia, lymphoma, and multiple myeloma. After the transplantation of stem cells, which help to regenerate the blood and immune system, patients often require extensive blood product support during the recovery phase. Stem cell transplants can lead to severe pancytopenia, where all types of blood cells (red blood cells, white blood cells, and platelets) are reduced. Blood transfusions are essential to support patients during this time, as they can help restore vital blood components, provide immune support, and reduce the risk of bleeding. The role of transfusion medicine in stem cell transplant patients is not just to provide immediate support but also to enable the long-term success of the transplant, ensuring the patient’s immune system and bone marrow can recover sufficiently to fight off infections and cancer cells [5].

In addition to the physical aspects of transfusion medicine, psychological considerations also play a role in the care of cancer patients who require frequent transfusions. The repetitive nature of blood product administration can be psychologically taxing for patients. For some, the need for continuous transfusions may serve as a reminder of the severity of their condition, contributing to feelings of anxiety and depression. A key aspect of transfusion medicine, therefore, is the holistic care of the patient, addressing not just the physical but also the emotional and psychological burdens associated with cancer treatment. Providing patients with clear information about the purpose and safety of transfusions, as well as offering emotional support, can help alleviate some of the anxiety that comes with frequent blood product usage. This integrated care approach ensures that cancer patients are treated as whole persons rather than focusing solely on the disease itself.

Conclusion

In conclusion, transfusion medicine is a cornerstone of care for cancer patients, providing crucial support to manage the hematologic complications that arise from both the cancer itself and its treatments. Through red blood cell, platelet, and plasma transfusions, as well as the management of coagulopathies and stem cell transplant patients, transfusion medicine helps sustain patients' health, improve their quality of life, and enable the continuation of cancer therapies. The role of transfusion medicine is multifaceted, incorporating not only clinical expertise but also emotional and psychological support for patients. As medical research continues to evolve, transfusion medicine will likely become even more refined, with advancements in gene therapy, cellular therapies, and blood management strategies offering new hope for cancer patients in the future.

Acknowledgement

None.

Conflict of Interest

None.

References

1. Ding, Lu, Lulin Xu, Yanxia Jin and Yongchang Wei, et al. "Efficacy of SXN in the treatment of iron deficiency anemia: A phase IV clinical trial." Evid.-Based Complement Altern Med 2019 (2019): 8796234.

Google Scholar, Crossref, Indexed at

2. Nakamoto, Hidetomo, Taku Mimura and Nobuko Honda. "Orally administrated Juzen‐taiho‐to/TJ‐48 ameliorates erythropoietin (rHuEPO)‐resistant anemia in patients on hemodialysis." Hemodial Int 12 (2008): S9-S14.

Google Scholar, Crossref, Indexed at

3. Cappellini, M. Domenica and Irene Motta. "Anemia in clinical practice definition and classification: does hemoglobin change with aging?." Semin Hematol 52 (2015): 261-269.

Google Scholar, Crossref, Indexed at

4. Leung, Alexander KC, Joseph M. Lam, Alex HC Wong and Kam L. Hon, et al. "Iron deficiency anemia: An updated review." Curr Pediatr Rev 20 (2024): 339-356.

Google Scholar, Crossref, Indexed at

5. Shander, Aryeh, Lawrence T. Goodnough, Mazyar Javidroozi and Michael Auerbach, et al. "Iron deficiency anemia-bridging the knowledge and practice gap." Transfus Med Rev 28 (2014): 156-166.

Google Scholar, Crossref, Indexed at