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Childhood cancer patients sometimes need blood transfusions when their bodies cannot make enough blood cells.
Cancers of the blood, such as leukemia and lymphoma, can affect the bone marrow, the soft inner portion of bones where blood cells are made. Different treatments for cancer can also affect the blood and bone marrow.
The heart pumps blood through a network of arteries and veins throughout the body. Blood carries oxygen and nutrients to the body’s organs and tissues.
Blood is made up of different components or parts:
Red blood cells and platelets are the most commonly transfused products. Whole blood is rarely, if ever, used. When donors give whole blood, it is usually separated into parts.
Childhood cancer patients with severe anemia may need transfusions of red blood cells. Anemia occurs when the body has a lower than normal number of red blood cells. It can also occur if red blood cells don’t have enough hemoglobin, an iron-rich protein in red blood cells that carries oxygen.
A red blood cell transfusion may take 2- 2 ½ hours. The time required for the procedure depends on the patient’s weight and the volume of blood product needed by the patient.
Childhood cancer patients sometimes need platelet transfusions if they have low platelet counts, a condition called thrombocytopenia.
A platelet transfusion may take 1-1 ½ hours. It depends on the patient’s weight and the transfusion volume.
White blood cell transfusions are rare. They are used for patients with severe infections that don’t respond to antibiotics. Granulocytes are the type of white blood cell that is transfused.
Plasma transfusions are given to childhood cancer patients who may be having problems with bleeding excessively. Plasma contains coagulation factors that help the blood to clot.
Most transfusions are done in a hospital setting, often in the hospital’s chemotherapy room, during a surgical procedure, or at a patient's bedside.
Patients should prepare to wait a few hours for their blood transfusion to begin. Once the doctor places an order for a blood product, the blood bank staff must go through a process to ensure the patient receives the appropriate product. Then the blood product must be delivered to the procedure area. That process can take 2 hours or more. If the patient is an outpatient, the family may want to find other things to do at the hospital during this period.
The transfusion itself may take 1-2 hours or longer. The time length depends on the type of transfusion, the volume of the product, and the weight of the patient. The care team can give families information specific to their child.
Most blood transfusions go smoothly. However, some patients may have reactions to transfusions. In some cases, the reaction can be treated and the transfusion can continue. In other cases, the care team will stop the transfusion.
Symptoms of a reaction can include:
In rare cases a severe reaction called a hemolytic transfusion reaction may happen. It occurs if the blood type the patient is given during a transfusion doesn't match or work with the patient’s blood type. The body attacks the new blood cells, which then produce substances that can harm the kidneys.
The nurse will stop the transfusion at the first sign of this reaction.
Parents should make sure to report any of these signs and symptoms to the care team.
Hospitals receive blood products from blood centers, which are facilities that collect, prepare, store, and distribute blood for transfusion. Some blood centers are freestanding. Others are part of a hospital.
Blood products are most often donated by volunteer blood donors. Sometimes families donate blood for a specific patient. In some cases, the patient’s own blood can be used. But that is usually not possible for childhood cancer patients.
A patient must receive a blood product that works with his or her blood type. If the blood product isn’t compatible, antibodies in the blood will attack the donor blood and make the patient ill.
Every person has a blood type – O, A, B, or AB. It is either Rh-positive or Rh-negative. The types of blood are:
Blood banks type and match blood products to make sure they are compatible with the recipient’s blood.
The Food and Drug Administration (FDA) regulates blood donations. Blood banks take several precautions to ensure the safety of the blood supply.
Because of the stringent screening involved, blood products in the United States are very safe. Chances of getting an illness because of a blood transfusion are rare.
For more information about blood safety, visit the CDC's Blood Safety Basics.
Reviewed: June 2018