3.2 Effect of red blood cell transfusion on outcomes

3.2.4 Cancer

Evidence statements for Cancer

Evidence Statements – cancer
ES2.8	In patients with cancer, RBC transfusion may be associated with an increased risk of in-hospital mortality.		NA
ES2.9	In patients with cancer, RBC transfusion may be associated with an increased risk of in-hospital venous and arterial thromboembolic events.		NA

ES, evidence statement; RBC, red blood cell

=A; =B; =C; NA,not applicable (see Table 2.1)

Practice Points – cancer

PP8	In patients with cancer, the aetiology of anaemia is often multifactorial; where appropriate, reversible causes should be identified and treated.
PP9	There is a lack of specific evidence relating to the effects of RBC transfusion in patients with cancer. Any decision to transfuse should be based on the need to relieve clinical signs and symptoms of anaemia. When treating patients with cancer, refer also to the general medical population PP1–PP4.

PP, practice point; RBC, red blood cell

A single fair-quality retrospective cohort study (Level III-2) reported an increased risk of mortality and of venous and arterial thrombotic events in transfused hospitalised patients with cancer.⁹⁰ This study provides insufficient evidence on which to base evidence-based recommendations.

In the absence of strong evidence, guidance relating to transfusion policies in this patient group can be found in practice points made by the CRG, and extrapolated from experience in other patient populations.