Transfusion Support

Blood cancer patients are among the highest users of blood products, receiving approximately one-third of all red blood cell transfusions and 60% of all platelet transfusions in Australia. This comes at a major financial cost to the healthcare system and carries potential risks for patients.

Despite how common this practice is, the clinical evidence guiding when and how to give these transfusions is surprisingly weak. Current guidelines are mostly borrowed from other areas of medicine, like elective surgery. However, blood cancer patients have vastly different needs due to the severity of their illness, exposure to toxic therapies, and their reliance on long-term transfusion support.

Patients with blood cancer frequently have low blood counts including anaemia (low red blood cells) which can cause symptoms of fatigue, shortness of breath and reduced exercise tolerance, and thrombocytopenia (low platelet count) which increases bleeding risk. Treatments commonly used for blood cancer, such as chemotherapy, radiotherapy, disease modifying drugs, bone marrow transplantation and newer immunotherapies can also cause low blood counts. Consequently, many patients require red blood cell or platelet transfusion. Patients with blood cancer are amongst the higher users of blood products, receiving approximately one third of all red blood cell transfusions and nearly two thirds of all platelet transfusions in Australia. 

Despite how commonly transfusions are given, the clinical evidence guiding when and how to best provide transfusion support to patients with blood cancers is surprisingly weak. Current guidelines are often extrapolated from other areas of medicine, like surgery. However, patients with blood cancer have vastly different needs due to the severity and chronicity of their illness, exposure to therapies that may worsen their blood counts, and their reliance on long-term transfusion support. Our research priorities include:    
   
• Optimising red blood cell transfusion strategies in patients with blood cancers        
• Optimising methods of delivering transfusion support
• Gaining greater understanding of bleeding risk in patients with blood cancer       
• Optimising supportive treatments for low platelet counts to prevent bleeding