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The Leukemia/Bone Marrow Transplant Program of BC

For Patients & Families
Complications & Side Effects

Bleeding & Transfusion

Bleeding as a Side Effect

Patients receiving chemotherapy or having a bone marrow transplant will have a period of time when their platelet count is low. Platelets are responsible for promoting clotting of the blood, and when they are low, patients are prone to bleeding (hemorrhage).

Patients with low platelet counts may also experience excessive bruising, but this is not generally a serious complication. On the other hand, when bleeding occurs from the gastrointestinal tract or into the lungs or brain, this can be life-threatening.

Management

The risk of serious hemorrhage is minimised by transfusion of platelets when the platelet count is less than 10. In situations where patients are already bleeding or have a high fever, platelet counts are usually kept at an even higher level.

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Transfusion Risks, Side Effects & Management

Everything possible is done to reduce the risks associated with blood transfusions; however, you should be aware of the possible risks:

  1. Viral infections: Although blood products are rigorously tested and screened for viruses before being released by the Canadian Blood Services, it is possible that viruses may be transmitted to a patient through a transfusion. The risk of this is exceedingly low. While any blood transfusion that can be avoided, will be; the benefits of blood product transfusion in BMT patients far outweigh the risks involved. You can get more information about the risks from your doctor.
  2. Allergic reactions: You might feel itchy or get a rash with transfusions. However, these reactions are easily treated with antihistamines and anti-inflammatories. Rarely, allergic reactions may be severe and produce shortness of breath or throat swelling.
  3. Fever, rigors, shakes: A reaction may occur from substances in the donor blood, which may result in a fever. The symptoms may consist of feeling cold or having chills, followed by a rapid rise in body temperature (fever). This response occurs during or shortly after the transfusion has been completed. If required, it can be controlled with simple medications such as acetaminophen or Tylenol. If you have had a history of fever reactions with prior transfusions, you should tell the doctor.
  4. Hemolytic reactions: This rare reaction occurs when antibodies in the patient's blood react against the donor red cells, destroying them. This is called hemolysis and can result in kidney failure. To ensure that the correct blood is given to prevent this reaction, careful blood testing, processing and administering procedures are required.
  5. Iron Overload: If blood product transfusion is required for an extended period of time, it is possible for the body to accumulate too much iron. This could lead to problems with liver or heart function. Once patients no longer require transfusions, blood may have to be removed from the body as medical therapy to remove excess iron. This procedure is called a phlebotomy. If patients with iron overload are still requiring transfusion, a drug (Desferal) can be prescribed to assist in iron excretion from the body.
  6. Previous reactions: You should let the doctor know if you have had a reaction from blood transfusions in the past, so that steps can be taken to prevent it from recurring.

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