When living with a blood cancer like leukemia, you likely find yourself feeling fatigued, short of breath, or just plain bad. The likely culprit behind your symptoms is low blood cell counts. These counts can be caused by the cancer itself or your treatment plan. Luckily, blood transfusions can help bring your counts up and make you feel better.

In this article, we’ll cover the types of blood transfusions you or a loved one with leukemia may receive. We’ll also go over how transfusions treat your symptoms and discuss any side effects or complications that can occur.

Types of Blood Transfusions for Leukemia

Your blood is made of several components that carry oxygen and nutrients throughout your body. Whole blood is made of around 55 percent plasma and 45 percent blood cells, accounting for between 7 percent and 8 percent of your body weight. Plasma is the liquid portion of your blood that comprises proteins, nutrients, and clotting factors.

People with leukemia and other blood cancers often receive blood transfusions throughout their disease. These transfusions don’t use whole blood — instead, a doctor or hematologist (blood specialist) will decide which components you need based on your latest blood cell counts.

Examples of blood components (or blood products) you may receive in a transfusion include:

• Red blood cells — These cells contain the protein hemoglobin that carries oxygen throughout your body.
• Granulocytes or white blood cells — These cells are part of your immune system and help fight infections.
• Platelets — These sticky cell fragments help form blood clots to stop bleeding.
• Gamma globulin — This collection of antibodies from healthy donors helps prevent infections.
• Plasma and cryoprecipitate — This component contains clotting factors that help prevent or treat excessive bleeding.

The components used in a transfusion come from donated blood that’s filtered and treated with radiation to prevent complications.

Blood transfusions are typically done in an outpatient clinic or hospital. During your transfusion, you’ll have a needle inserted in a vein in your arm to deliver the components. A nurse will monitor you throughout treatment to make sure you don’t have a reaction. The length of time varies depending on what components you’re receiving.

Check out five things you should know about blood transfusions and how they might become part of your life with leukemia.

1. Red Blood Cell Transfusions Help Treat Anemia Fatigue

Leukemia happens when the bone marrow, which is the spongy tissue inside your bones that makes blood cells, produces too many abnormal white blood cells. In leukemia, the abnormal cells crowd your bone marrow, stopping it from making new red blood cells. As a result, you may develop anemia (a low red blood cell count).

Anemia can also be a side effect of cancer treatments that affect your bone marrow, including chemotherapy and radiation therapy. These treatments target rapidly dividing cells, including your blood cells. Signs of anemia to look out for include:

• Having trouble breathing or shortness of breath
• Experiencing chest pain
• Feeling fatigued
• Feeling lightheaded or dizzy
• Having a fast breathing rate and heartbeat

If your red blood cell count or hemoglobin levels are too low, your doctor may order a red blood cell transfusion. MyLeukemiaTeam members have reported that their transfusions often help relieve their anemia symptoms. One shared, “It’s been going much better since I got my blood transfusion. I didn’t realize how tired I was until after it. I had the transfusion because of my anemia.”

2. Platelet Transfusions Can Lower Your Bleeding Risk

Leukemia and cancer treatments can also cause your platelet counts to drop. A healthy platelet count is between 150,000 and 400,000 platelets per microliter of blood. Without enough platelets, your blood can’t clot properly — this leads to easy bleeding and bruising.

Thrombocytopenia (low platelet count) is diagnosed when your platelet count drops below 140,000 platelets/microliter. You may have thrombocytopenia if you’re experiencing frequent nose bleeds or see petechiae, which are tiny discolored spots on your skin. These spots can be red, purplish, or dark brown depending on your skin tone.

Fortunately, your doctor can order a platelet transfusion to help bring your counts up. Platelets can be separated from other blood components from a single donor, or they can be concentrated from several donors. They’re filtered to remove white blood cells and are treated to avoid triggering an autoimmune reaction known as graft-versus-host disease (GVHD).

3. Granulocyte and Gamma Globulin Transfusions Help Prevent Infections

Many people with leukemia have high white blood cell counts — but these leukemic white blood cells are abnormal and can’t protect against bacteria and viruses. Many cancer treatments like chemotherapy, radiation, and immunotherapy block immune system function as well. When your immune system is blocked, you’re more vulnerable to infections.

If you’ve been running fevers often or having infections or illnesses that just don’t seem to go away, you might need a blood transfusion. Your doctor may order a granulocyte transfusion to help treat an infection that isn’t getting better with antibiotics or antifungal medication.

Intravenous immunoglobulin (IVIG) or gamma globulin is another option for boosting your immune system while living with leukemia. A stem cell transplant is when healthy stem cells are introduced into the body to replace diseased cells. You may receive IVIG infusions if you’re recovering from a stem cell transplant or chemotherapy treatment.

4. Plasma and Cryoprecipitate Transfusions Can Boost Clotting Factors

Your liver makes important proteins that help your blood clot, known as clotting factors. One type of acute myeloid leukemia (AML) — known as acute promyelocytic leukemia (APL) — causes the breakdown of clotting factors in the bloodstream. If you’re living with APL, you’re at an increased risk of bleeding, similar to thrombocytopenia.

Fortunately, fresh frozen plasma collected from donors contains a component known as cryoprecipitate. It contains the clotting factors needed to prevent bleeding or stop a major bleeding event. Your doctor may order a plasma and cryoprecipitate transfusion if you have APL and low clotting factor levels.

5. Blood Transfusions May Cause Side Effects

Like any treatment, a blood transfusion can have some side effects. Normally, these side effects outweigh the complications that can happen with low blood cell counts.

The most common side effect is fever — also known as a febrile reaction. This fever occurs because your body’s immune system is reacting to the new blood cells and components. A fever can start during your transfusion and last up to 24 hours afterward. You may be given acetaminophen (Tylenol) during the transfusion to help.

Other side effects that can occur include:

• Chills
• Nausea
• Headaches
• An allergic reaction that causes hives or itchy red, dark-red, or purple bumps on your skin (depending on your skin tone)
• Shortness of breath
• Pain at the transfusion site (where they place the needle in your arm)
• A drop in blood pressure

MyLeukemiaTeam members often ask one another about their experiences with transfusion reactions. “Anyone else get IVIG infusions? Do you feel fatigued or sickly afterward? I do for like four days, not sure if this is normal.”

One member replied, “I was almost done with my second dose when I had to be rushed to the emergency room. I had a bad reaction, so I can’t do them anymore.” Another shared, “I’ve had two blood transfusions, but both of those didn’t go so well for me, I had reactions from both.”

Repeated red blood cell transfusions can also lead to a complication known as iron overload. “Does anybody here have the same issue as me? Just found out my ferritin level is high, it could be the result of all of my blood transfusions last year.”

Iron overload can damage your liver and heart, so your doctor may use a special medication known as an iron chelator to remove the extra iron.

Blood transfusions are a key part of treating leukemia, providing help for people living with this disease. Transfusions deliver not only red blood cells but also platelets and other vital blood components, making life easier when it comes to anemia, bleeding issues, and the side effects of treatment.

Talk With Others Who Understand

MyLeukemiaTeam is the online social network for people with leukemia and their loved ones. On MyLeukemiaTeam, more than 15,000 members come together to ask questions, give advice, and share their stories with others who understand life with leukemia.

Have you had a blood transfusion while living with leukemia? How did your transfusion help treat your symptoms? Did you have any side effects? Share your experiences in the comments below, or start a conversation by posting on your Activities page.