Dasararaju Radhika, Marques Marisa B
Department of Pathology, University of Alabama at Birmingham, 35249, USA.
Cancer Control. 2015 Jan;22(1):16-25. doi: 10.1177/107327481502200104.
Patients with malignancy comprise a unique group for whom transfusions play an important role. Because the need for transfusions may span a long period of time, these patients may be at risk for more adverse events due to transfusion than other patient groups.
A literature search on PubMed that included original studies and reviews was performed. The results were summarized and complemented by our clinical experience. Long-term complications of transfusions, such as transfusion-associated graft-vs-host disease, alloimmunization, transfusion-related immunomodulation, and iron overload, are discussed.
Transfusion-related acute lung injury, transfusion-associated circulatory overload, and hemolytic transfusion reaction are deadly complications from transfusion. These adverse events have nonspecific presentations and may be missed or confused with a patient's underlying condition. Thus, a high level of suspicion and close monitoring of the patient during and following the transfusion is imperative. Common reactions (eg, febrile nonhemolytic transfusion reaction, allergic reaction) are not life threatening, but they may cause discomfort and blood product wastage.
Every transfusion carries risks of immediate and delayed adverse events. Therefore, oncologists should prescribe transfusion for patients with cancer only when absolutely necessary.
恶性肿瘤患者是一个独特的群体，输血对他们起着重要作用。由于输血需求可能持续很长时间，与其他患者群体相比，这些患者因输血发生更多不良事件的风险可能更高。
在PubMed上进行了一项文献检索，包括原始研究和综述。结果通过我们的临床经验进行总结和补充。讨论了输血的长期并发症，如输血相关移植物抗宿主病、同种免疫、输血相关免疫调节和铁过载。
输血相关急性肺损伤、输血相关循环超负荷和溶血性输血反应是输血的致命并发症。这些不良事件表现不具特异性，可能被漏诊或与患者的基础疾病相混淆。因此，在输血期间和输血后对患者进行高度怀疑和密切监测至关重要。常见反应（如发热性非溶血性输血反应、过敏反应）虽不危及生命，但可能会引起不适并造成血液制品浪费。
每次输血都有发生即刻和延迟不良事件的风险。因此，肿瘤学家应仅在绝对必要时才为癌症患者开具输血医嘱。
