Blood Transfusions

Most people who have a bone marrow failure disease like aplastic anemia, MDS or PNH will receive at least one blood transfusion. When you receive a blood transfusion, the cell parts of blood from a donor are put into your bloodstream. This can help some patients with low blood counts.

The 2 types of transfusion typically used for bone marrow failure disease patients are:

White blood cells live for a very short time, so patients with a low white count rarely get transfusions of white blood cells.

Red Blood Cell Transfusion

The U.S. Blood Supply

The U.S. blood supply is among the safest in the world, according to the CDC (U.S. Centers for Disease Control and Prevention). Blood collected in the U.S. is checked carefully for diseases like HIV (the virus that causes AIDS) and hepatitis. Any blood and blood products that have these diseases are safely discarded and are not used. At this time, the risk of getting an infection in the United States through getting a blood transfusion or blood products is extremely low.

If you don't have enough healthy red blood cells (anemia), your doctor may ask you to get a red blood cell transfusion. It usually takes 2 to 5 hours to complete. Depending on how low your blood count is, you may need a transfusion as often as every 2 weeks. Or, you may need it only once in a while. You can have transfusions as often as needed.

Here's what to expect:

Before the transfusion:

  • Your blood will be tested to make sure it matches the donor blood. This usually takes about 1 hour.
  • Donor blood may be filtered and irradiated to remove and deactivate certain cells. This process lowers your risk of having a bad immune response to the blood called graft-versus-host-disease (GVHD).
  • Your doctor may order Tylenol® and Benadryl® before the transfusion to help prevent fever, chills, and allergic reaction.
  • You may get a gel called EMLA to numb the area where the needle will enter.
  • You will get an IV in your vein.

During the transfusion:

  • Your nurse will check your vital signs – temperature, heartbeats per minute, breaths per minute, and blood pressure.
  • You will get 1 to 3 units of red blood cells without plasma (packed red blood cells)

After the transfusion:

  • If you took Benadryl®, you may feel drowsy.

Side effects of red blood cell transfusion

A red blood cell transfusion carries the risk of certain side effects:

  • After you get many transfusions iron may build up in your body (iron overload). This can put your organs at risk. Iron overload can happen after as few as 10 red blood cell transfusions (20 units). Iron overload can be treated with iron chelators. Learn more about iron overload and iron chelation.
  • You may have an allergic reaction.
  • You might have a fever.
  • You might develop a rash or hives.

Platelet Transfusion

Beware of Blood From Relatives

Q: I just learned that I have aplastic anemia, and I need a transfusion. My mom offered to donate blood, but my doctor says I can't use it yet. Why not?
A: As a close family member, your mom could turn out to be a match for a stem cell transplant. If you've already received blood from her, the transplant could have less chance of success. So until she donates stem cells to you, or she is ruled out as a stem cell donor, it's best to use blood from someone who is not related to you.

If you don't have enough healthy platelets in your blood or if you are bleeding, you may get a platelet transfusion. This condition is called thrombocytopenia. Patients with a low platelet count tend to bruise and bleed easily. A platelet count of less than 10,000 per microliter of blood is considered low enough to need a platelet transfusion.
At first, a platelet transfusion helps for about 7 days. But after you have had many platelet transfusions, they may not help as long.

Things to know about platelets:

  • Platelets live just 8 to 10 days. So transfusion helps for only a short time.
  • Some patients choose to avoid transfusion unless they are bleeding. Other patients need transfusions a couple of times a week to prevent uncontrolled bleeding.
  • Each person reacts differently to a low platelet count.

Side Effects of Platelet Transfusion

Platelets are more likely than red blood cells to cause an immune response. So you are more likely to have side effects like chills and fever. Your body is quicker to develop antibodies against platelets than against red blood cells. This can cause platelet transfusions to fail after repeated transfusions.

The FDA (U.S. Food and Drug Administration) has not yet approved any medicines that cause the bone marrow to make more platelets (platelet growth factors). But research is being done to develop them.