Transfusion Medicine in Oncology

Transfusion Medicine has an important part in the ancillary care of oncology, hematology, and hematopoietic stem cell transplants (HSCT) patients receiving chemotherapy and radiation therapy. During the treatment, patients may develop pancytopenia and may need regular transfusion aid until they recover from the effect of therapy. Multiply transfused patients are predisposed to alloimmunization and platelet refractoriness. Some patients may need blood components with modifications like leukoreduction, irradiation, saline washing, and HLA matching. Transfusion of blood components should be based on evidence-based practice and guidelines. There are various international guidelines for transfusion practices like Association for the Advancement of Blood and Biotherapies (AABB), British Committee for Standards in Haematology (BCSH), Joint United Kingdom (UK) Blood Transfusion, and Tissue Transplantation Services Professional Advisory Committee with Indian guidelines as per DGHS Technical Manual. Blood transfusions can be lifesaving but can also be coupled with adverse effects/complications. These complications can be categorized as mainly immune or nonimmune mediated, acute, or delayed and infectious or noninfectious. Likewise, HSCT patients may have complications like chimerism, which pose hindrance in choosing of appropriate blood components. This chapter deals with challenges of transfusion assistance in managing hemato-oncology and stem cell transplant patients.