Blood transfusion and patient blood management in cancer patients

Anemia is common in cancer patients and linked to higher mortality, longer hospital stays, and reduced survival. Iron deficiency and the second most common form of anemia, anemia of chronic disease caused by elevated hepcidin levels, limit iron availability. Although red blood cell (RBC = transfusions quickly raise hemoglobin levels, they are associated with increased risks of tumor recurrence, infections, and reduced cancer-specific survival. Intravenous iron therapy and/or erythropoiesis-stimulating agents (ESAs) are effective alternatives to manage anemia. Patient Blood Management (PBM) offers a structured strategy to reduce transfusions by multiple approaches such as preoperative iron therapy, restrictive transfusion strategy and conserving blood during surgery. Clinical studies have shown that PBM significantly reduced transfusion rates, lowered infection risks, and shortened hospital stays without compromising safety. An individualized therapeutic approach seems beneficial in oncologic patients.