People with MDS have fewer red and white blood cells and platelets. Blood transfusions may be needed if you have MDS and experience anemia or thrombocytopenia.
Myelodysplastic syndromes (MDS) are a group of disorders that affect the way new red blood cells and platelets are produced in your bone marrow.
There are two types of blood transfusions for MDS, which may be needed to help manage different conditions:
- Red blood cells: Up to 9 in 10 people with MDS will need red blood cell transfusions to treat anemia.
- Platelets: As many as 1 in 2 people may need platelet transfusions to treat thrombocytopenia.
Keep reading to learn more about what to expect during blood transfusions for MDS.
New red blood cells and platelets are made in your bone marrow, the spongy tissue inside bones. Damage from MDS prevents the bone marrow from making enough healthy red blood cells and platelets.
Red blood cell transfusion
Red blood cells carry oxygen from your lungs to the rest of your body. Having too few red blood cells is called anemia, which may cause symptoms like:
- fatigue
- shortness of breath
- heart palpitations
- headaches
- pale skin
Research suggests anemia is very common in people with MDS. Red blood cell transfusions are therefore common to help reduce symptoms of anemia and to prevent complications, such as heart attack and heart disease.
Platelet transfusions
Platelets are responsible for clotting blood to help prevent excessive bleeding. Having too few platelets is called thrombocytopenia, and it can cause bruising or bleeding more easily.
Platelet transfusions may be necessary to help reduce severe bleeding.
The frequency of blood transfusions for MDS depends on your red blood cell and platelet counts.
Some people with MDS need transfusions every couple of weeks. Others can go months without needing a transfusion. Platelet transfusions are needed more often because these blood cells can only survive for 7 to 10 days.
Your doctor will monitor your red blood cells and platelet counts, and they’ll let you know how often you need transfusions based on these test results.
The blood you’ll receive during transfusions comes from a healthy donor.
First, your blood type and the donor’s blood type are tested to make sure they match. Getting a blood type that doesn’t match your own could cause a dangerous reaction.
These are the steps involved in a blood transfusion:
- A technician disinfects the skin before using a needle to place an intravenous (IV) line into a blood vessel, usually in your arm.
- The donor blood drips from a bag through the IV line into your blood vessel. This process is called transfusion. You’ll be watched closely during at least part of this time to make sure you don’t have a reaction.
- After enough blood has been transfused, the technician removes the IV line and checks your vital signs, such as temperature, heart rate, and blood pressure.
Where are they performed?
Most blood transfusions are done in a hospital, clinic, or doctor’s office. In
How long do they take?
According to the
Blood transfusions are part of supportive care for MDS.
They could help relieve symptoms and prevent complications related to anemia and thrombocytopenia, as well as provide extra support for people who require further treatments after trying growth factors, immunomodulators, and other MDS medications.
Blood transfusions can also be a short-term treatment for a low blood cell count caused by a medication you take.
Blood transfusions are considered safe, but there’s still a risk of developing different types of reactions. These can happen within minutes to days after the transfusion.
It’s common to experience fever within
The following reactions, however, may be more serious and require immediate medical attention:
Allergic reactions
This is the
Symptoms include hives and itching, which you can usually treat with antihistamines.
Acute immune hemolytic reactions
This very serious reaction happens when your blood type and your donor’s blood type don’t match. Your immune system attacks the new red blood cells, which makes them break open and release toxins into your blood.
Acute immune hemolytic reactions are rare today because donors and recipients are matched so carefully, but if you do have this type of reaction, your technician will stop the transfusion immediately.
Transfusion-related acute lung injuries (TRALI)
Rarely, the transfusion may activate immune cells in the lungs, which causes fluid buildup and lung damage.
TRALI is more common in people who are already very sick. If you have trouble breathing, which is a symptom of TRALI, your technician will stop the transfusion.
Infections
Before a blood transfusion, healthcare professionals rigorously test the donor’s blood for any infections.
Despite this, the American Red Cross notes that transmission of the following infections is still possible, though extremely rare:
- HIV
- Hepatitis B and C
- West Nile virus
Iron overload
Iron overload is another possible, less immediate risk.
Blood contains iron, and after you’ve had about
Some people become dependent on blood transfusions, which means they need multiple red blood cell transfusions a month. Being dependent on transfusions may lead to worse health outcomes.
Caring for MDS is expensive, especially if you need transfusions.
A 2022 review found that the average medical cost for people who required transfusions was $88,824, compared to $29,519 for those who didn’t.
The authors note that transfusions added an extra 50% of costs per month.
It’s important to note that these numbers estimate the total value of the medication used, infusions given, and other healthcare expenses, so they don’t necessarily reflect what an individual with insurance coverage would pay.
If you have insurance, the costs may differ based on your plan. If you don’t have insurance, speak with your doctor to see if they provide payment plans or reduced rates for self-payers.
MDS treatments come in two types: supportive care and drug therapy.
Blood transfusions are a type of supportive care, according to the
Growth factors are another supportive treatment. They help your bone marrow make new blood cells and may reduce your need for transfusions.
The following growth factors may help your body make more red blood cells:
- epoetin (Epogen, Procrit)
- darbepoetin alfa (Aranesp)
These growth factors help your body make more platelets:
- romiplostim (Nplate)
- eltrombopag (Promacta)
These are some other treatments that may reduce the need for transfusions:
- lenalidomide (Revlimid)
- luspatercept (Reblozyl)
- antithymocyte globulin (ATG), an immune-suppressing medication
- chemotherapy drugs like azacitidine (Vidaza) or decitabine (Dacogen)
What is the life expectancy of a blood transfusion patient?
Some research suggests that the life expectancy for someone with low risk MDS who is receiving red blood cell transfusions is 2.4 to 11.8 years.
Learn more about the life expectancy and outlook for MDS.
Are blood transfusions considered palliative care?
Blood transfusions may be considered a form of palliative care because they help relieve symptoms, prevent complications, and improve quality of life.
Transfusions give you the red blood cells and platelets that your body is missing with MDS, helping to relieve MDS symptoms.
The downsides are that transfusions are expensive and they have some potential side effects, including reactions and iron overload.
Other MDS treatments, such as growth factors and immune-suppressing medications, may help reduce your need for transfusions.