Cancer patients often require blood transfusions due to anemia, thrombocytopenia, or other blood-related complications. These transfusions, while lifesaving, can sometimes lead to
transfusion reactions, which are adverse responses by the recipient's body to the transfused blood components. Understanding these reactions is crucial for managing them effectively.
What are Transfusion Reactions?
Transfusion reactions are adverse events that occur during or after a blood transfusion. They range from mild allergic reactions to severe, life-threatening conditions. These reactions can be acute or delayed, with acute reactions occurring within 24 hours of the transfusion and delayed reactions manifesting days or weeks later.Types of Transfusion Reactions
Various types of transfusion reactions can occur in cancer patients: Febrile Non-Hemolytic Transfusion Reactions (FNHTR): These are the most common reactions, characterized by fever and chills. They are usually mild and occur due to cytokines or antibodies reacting with white blood cells in the transfused blood.
Allergic Reactions: These reactions are caused by recipient antibodies reacting to proteins in the donor plasma. Symptoms include itching, rash, and sometimes more severe anaphylactic reactions.
Acute Hemolytic Transfusion Reactions: These are serious reactions caused by the recipient's immune system attacking the transfused red blood cells. Symptoms include fever, chills, back pain, and dark urine.
Transfusion-Related Acute Lung Injury (TRALI): A serious but rare reaction causing acute respiratory distress. It is associated with antibodies in the donor blood reacting with recipient white blood cells.
Delayed Hemolytic Reactions: These occur when the recipient's body slowly destroys transfused RBCs days to weeks after the transfusion. It can result in anemia and jaundice.
Immediate Cessation: Stop the transfusion immediately if a reaction is suspected to prevent further complications.
Supportive Care: Administer antipyretics for fever, antihistamines for allergic reactions, and oxygen or ventilatory support for respiratory distress.
Investigation and Diagnosis: Conduct laboratory tests to identify the type of reaction and confirm the diagnosis. This may include direct antiglobulin tests, blood cultures, and chest X-rays.
Prevention in Future Transfusions: Use leukoreduced or washed blood products, especially in patients with a history of FNHTR or allergic reactions. For TRALI, avoid plasma from donors with a history of pregnancy, which can reduce the risk.
Can Transfusion Reactions Be Prevented?
While not all transfusion reactions can be prevented, certain measures can reduce the risk: Using leukoreduced blood products to minimize the risk of FNHTR and alloimmunization.
Pre-transfusion testing, such as crossmatching and antibody screening, to ensure compatibility.
Close monitoring of the patient during and after the transfusion to detect early signs of a reaction.
Conducting thorough pre-transfusion evaluations and obtaining informed consent.
Educating patients about potential risks and symptoms of transfusion reactions.
Implementing institutional protocols for the safe administration of blood products.
Reporting any adverse reactions to national hemovigilance systems to improve safety and protocols.
Conclusion
Transfusion reactions, though a risk in the treatment of cancer patients, can be effectively managed with vigilance and appropriate intervention strategies. Continuous education, research, and adherence to protocols help minimize these risks, ensuring that transfusions remain a vital part of supportive care in oncology.
