This information is about blood transfusions, which are used to treat anaemia in people having cancer treatment.
Anaemia is a reduction in the number of red blood cells in the blood. Many people with cancer will develop it at some point during their illness. This can be due to the cancer or its treatment, including chemotherapy and radiotherapy.
If the number of red blood cells in your blood is low, you may become very tired and feel like you have no energy. You may also become breathless. These symptoms occur because the red blood cells contain haemoglobin (Hb), which carries oxygen around the body.
You will have a blood test to check your haemoglobin level if you have symptoms of anaemia or are having cancer treatment. This is known as a full blood count (FBC). Your doctors may recommend that you have a blood transfusion if your haemoglobin level is low. A blood transfusion involves having blood given into one of your veins by a drip (infusion).
The transfusion increases the number of red blood cells in your blood, which means that more oxygen can be carried around the body to the tissues and organs. You will then have more energy and the breathlessness will be eased.
There are different treatments for anaemia depending on what's causing it. Blood transfusions are a simple way of treating anaemia. The symptoms of anaemia are often relieved quickly, and you should notice a benefit 24 hours after having the transfusion.
Transfusions may be used alone or together with other forms of treatment for anaemia. The beneficial effects of a blood transfusion can be temporary and some people may need further transfusions.
Having a blood transfusion
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Before a blood transfusion is given, the blood must be cross-matched to ensure that it’s compatible with your own blood. This involves taking a sample of your blood to identify your blood group and matching it with suitable donor blood. This procedure ensures that the blood you are given will not make you unwell.
The transfusion itself involves a small tube called a cannula being placed into a vein in your hand or arm. This is connected to a drip. The blood is then run through the drip (infusion) into your bloodstream. Some people have a transfusion given through a larger tube put into a vein in the chest (central line) or the crook of their arm (PICC line).
Blood for transfusion is stored in small plastic bags. Each bag is called a unit of blood. Transfusions usually involve giving 2-4 units depending on how anaemic you are.
Each unit is given over a period of 1-4 hours. When the transfusion is finished, the cannula is removed.
If you need several units of blood you may need to stay in hospital overnight. However, a transfusion of only 1-2 units of blood can usually be given to you as an outpatient.
Possible side effects of blood transfusions
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During the transfusion, you will have your temperature, pulse and blood pressure checked regularly by the nurses to detect any reaction to the blood. Common side effects that can occur are headaches, a slight rise in temperature or a skin rash. These effects can be relieved by drugs such as paracetamol. Severe side effects from blood transfusions are rare because blood is cross-matched first.
Having more than one blood transfusion
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Many people will need only one or two transfusions during their illness, although it is possible to have repeated transfusions if necessary. If you need to have lots of blood transfusions over many months, there is a very small risk of iron overload. This is only likely if you have had at least 20 transfusions.
Iron overload can happen because the red blood cells in each unit of blood contain a small amount of iron that builds up in the body. Iron overload is potentially harmful, and you may need treatment to help stop this from occurring. Your doctor or nurse will explain more about this treatment if necessary.
Are blood transfusions safe?
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Some people worry that the blood they are given may be infected by disease. People who donate blood are carefully screened to assess their risk of having an infection or virus such as hepatitis or HIV. This is to make sure the blood they donate is as safe as possible.
Other precautions are taken to minimise the risk of infection. All donated blood is tested in the laboratory for infection. Very occasionally, these tests fail to find an infection, but the risk of being given infected blood is extremely small.
If you have any concerns about receiving a blood transfusion, talk these over with your doctor or specialist nurse.
This information has been compiled using information from a number of reliable sources, including:
National Blood Service. www.blood.co.uk (accessed August 2012).
UK Blood and Transfusion and Tissue Transplantation Services. UK Blood and Transfusion and Tissue Transplantation Guidelines. 7th edition. www.transfusionguidelines.org.uk (accessed August 2012).
Hoffbrand, et al. Essential Haematology. 6th edition. 2011. Blackwell Science.
Thanks to Professor Rajnish Gupta, Consultant Medical Oncologist, and all of the people affected by cancer who reviewed this information.