Transfusion Support Of Patients Research Articles

Advances in Human Leukocyte Antigen Testing Technologies and Management Strategies for Platelet Transfusion Refractoriness.

The blood bank is often consulted for transfusion support of patients with suspected platelet transfusion refractoriness (PTR). The workup is complex because testing includes specialized assays that are uncommonly ordered with limited availability. Add to this the variety of possible products-crossmatched platelets, human leukocyte antigen (HLA)-matched platelets, HLA antigen-negative platelets-and the approach to PTR can be overwhelming. Moreover, most literature on the subject is published in transfusion medicine journals aimed at transfusion medicine physicians and blood bank specialists in academic settings. Resources tailored to community hospital blood banks are lacking. To provide pathologists who may not have subspecialized training in transfusion medicine and who direct blood banks algorithmic workflows based on clinical scenario and test availability to provide appropriate transfusion support for patients with PTR. This review is a comprehensive overview of terminology, HLA testing procedures, interpretations, and practical recommendations for managing PTR in various scenarios based on expert opinion as well as relevant medical literature published from 2007 to 2022. Consultation on PTR is complicated and encompasses many clinical and laboratory aspects. The lack of guidelines derived from high-quality prospective studies poses challenges in the workup and management of PTR. Hindering the process further are limited test availability, unfamiliarity with the technical assays, and the various specialized platelet products. The clinical evaluation algorithm presented herein along with the workflow pathways offer pathologists user-friendly and best-practice guidelines with different options based on the clinical scenario and the tests available.

Molecular typing of Kell, Kidd, and Duffy antigens in direct antiglobulin test-positive autoimmune hemolytic anemia patients.

In autoimmune hemolytic anemia (AIHA) patients, conventional pretransfusion testing is difficult to interpret due to the presence of autoantibodies which may show panreactivity. Molecular phenotyping of red cell antigens could potentially be used to precisely match blood units, thereby reducing the need to perform intensive serologic laboratory testing, hence time delay in providing transfusion to such patients. The aim of this study is to perform the molecular typing for Kell, Kidd, and Duffy blood group antigens in direct antiglobulin test (DAT)-positive red blood cells of AIHA patients and provide corresponding antigen-matched blood for transfusion therapy. Blood samples from 50 normal blood donors and 30 DAT-positive AIHA patients were tested using standard serological techniques and polymerase chain reaction-based methods for Kell (K/k), Kidd (Jka/Jkb), and Duffy (Fya/Fyb) blood group systems. Five patients requiring blood transfusion were given donor blood units identical for Kell, Kidd, and Duffy antigens and followed up. Genotyping and phenotyping results were 100% concordant for normal blood donors. Serological phenotyping of minor red cell antigens showed varied degree of agglutination for AIHA patients. The molecular typing was able to detect the antigen frequency accurately in all samples. The results of genotyping were used to provide Kell-, Kidd-, and Duffy-matched blood for transfusion therapy to AIHA patients with no adverse reaction. Molecular blood group typing has proved immensely useful in the determination of actual antigen profile and hence in providing appropriate transfusion support in patients with AIHA reduced risk of transfusion reactions and alloimmunization.

Prevalence of theDirect Antiglobulin Test and Its Clinical Impact on Multiply Transfused Thalassemia Patients: AProspective Study Conducted at aTertiary Care Center in Northern India.

This study was conducted to estimate prevalence of direct antiglobulin test (DAT) positivity and its impact on transfusion support in patients with thalassemia. The DAT testing was performed for patients with β-thalassemia who received transfusion from November 2021 to March 2022. Elution was done for DAT-positive samples. Of 180 patients, 21 (11.6%) were DAT positive. Immunoglobulin G (IgG) was present in 4 (19%) and IgG+C3d was present in 8 (38%). Only complement was present in 9 (42.8%) patients. The IgG-reactive DATs were associated with pan-reactive eluate. Patients who were DAT-positive had significantly higher levels of serum bilirubin, ferritin, and IgG than those who were DAT-negative. Autoantibody formation in multiply transfused thalassemia patients is common and merits equal attention as alloimmunization. It is particularly important as DAT-positive red bloodcells may undergo clinically significant hemolysis, which may increase the transfusion requirements with associated sequalae such as increased serum ferritin and splenomegaly.

Transfusion support for patients with sickle cell disease

Red blood cell (RBC) transfusion is an essential treatment for many patients with sickle cell disease (SCD), whose RBCs express hemoglobin S (HbS), a mutated form of hemoglobin A (HbA). Transfusion goals include increasing blood oxygen carrying capacity and decreasing the relative amount of HbS to HbA to mitigate vaso-occlusion in small blood vessels. In situations where correction of severe anemia and reduction in HbS may be achieved without removal of RBCs, simple transfusion may be utilized. Partial manual RBC exchange, which removes blood containing HbS by phlebotomy and replaces with donor blood transfusion sequentially allows for larger changes in the ratio of HbS to HbA when compared to simple transfusion. Automated RBC exchange by apheresis is useful in situations where a rapid and drastic HbS reduction is indicated. Vascular access is an important consideration for transfusion. Although peripheral access may be sufficient, central venous catheters and implantable venous access devices may be necessary for adequate access over time. Blood bank considerations include adequate RBC antigen matching to mitigate the risk of RBC alloimmunization, of which patients with SCD are at risk of developing. Transfusion may be utilized in efforts to intervene in the evolution of potentially life-threatening complications of SCD such as acute stroke, severe acute anemia and acute chest syndrome. Transfusion is also useful in several non-acute settings, such as stroke prevention, pregnancy, pre-surgery, and transfusion support for curative therapies. Individualized treatment plans are an essential component of patient care. Continuous evaluation of clinical indications and evolution of guidelines will continue to optimize care for patients with SCD.

Evan’s Syndrome: Case Series with Review of Literature

Evans syndrome is a rare autoimmune disease in which an individual’s antibodies attack the body’s own red blood cells and platelets. It is characterised by simultaneous or sequential development of Immune Thrombocytopenic Purpura (ITP) and Autoimmune Hemolytic Anemia (AIHA) with positive Direct Antiglobulin test (DAT). AIHA can be cold, warm or mixed type depending on the type of antibody. 80% of total AIHA cases are warm AIHA. Warm AIHA is mostly caused by IgG antibody which reacts at 370 C. Warm AIHA is associated with classical case of Evan’s syndrome. Some variants of Evan’s syndrome are associated with leucocytosis. The current article discusses 3 cases of Evan’s syndrome, all presenting differently - Classical Evan’s syndrome, Evan’s syndrome associated with leucocytosis and Evan’s syndrome associated with neuropathic pain. In this case series, pathophysiology, workup done at blood centre and blood component transfusion support in patients with Evan’s syndrome has been discussed. Keywords: Evan’s syndrome, Anemia, Autoimmune

RHCE diversity among Brazilian patients with sickle cell disease (SCD) and selected groups of blood donors.

Several centers have selected Black donors to prevent Rh alloimmunization of patients with sickle cell disease (SCD). As the Brazilian population is considered very admixed and race definition by self-declaration is questionable, this study aimed to compare RHCE diversity among patients with SCD and selected groups of Brazilian blood donors to define which group of donors would be the adequate red cell supply for patients with SCD. We compared RHCE allele frequencies between patients with SCD and four groups of Brazilian blood donors: self-declared Black donors (SDB), donors with predominant African genetic markers (AAM), donors with weak D expression (WDD), and random donors (RDs). Variant RHCE alleles were identified using molecular protocols. Among patients with SCD, 47% had at least one variant RHCE, in SDB and WDD this frequency was higher, 53% and 58.6%, respectively. In AAM and in RD the frequencies were 32% and 27.6%, respectively. In patients with SCD and SDB, the most common alleles were RHCE*ce.01, RHCE*ceVS.01, and RHCE*ceVS.02. WDD had a high frequency of RHCE*ceAR and highest frequency of variant RHCE in both alleles, followed by patients with SCD and SDB. This study showed that even in an admixed population the selection of SDB donors is the best choice of matching for transfusion support in patients with SCD. For specific RHCE alleles, selection of donors with weak D expression could be a good option.

Immunohematology and Transfusion Support of a Patient with Acute Myeloid Leukemia and an Anti-Vel

BackgroundTransfusion support of cancer patients presenting with red blood cell (RBC) antibodies against high-incidence antigens is a challenge for hospital-based Transfusion Services. For patients with antibodies against the high-frequency Vel antigen, only 0.0004% of blood donors will be Vel antigen-negative. Anti-Vel is notorious for looking like a benign, cold-reactive IgM antibody or a “high-titer, low-avidity” antibody; however, Vel-antibodies can fix complement at body temperatures and can cause severe hemolytic transfusion reactions. The immunohematology workup and RBC transfusion support are reported for a patient who developed an anti-Vel and other RBC antibodies during chronic transfusion therapy for myelodysplastic syndrome, with progression to acute myeloid leukemia. She was also evaluated for hematopoietic stem cell transplantation (HSCT).MethodsImmunohematologic workups were performed at a regional immunohematology reference laboratory. Since the patient had a positive autocontrol and a positive direct antiglobulin test (DAT), allogeneic adsorptions were performed at 37°C using R1R1, R2R2 and rr RBC reagents. Adsorbed plasma and eluates from adsorbed RBCs were then tested for alloantibody detection using manual tube method at both LISS and PEG reactivity. In preparation for possible HSCT, RBC alloantibody titers and monocyte monolayer assay (MMA) were performed. All samples were collected with pediatric phlebotomy tubes whenever possible.ResultsThe patient was a 66 year old woman with a myelodysplastic syndrome that transformed to acute myeloid leukemia (AML) with complex karyotype a year later. The RBC reference workup identified alloantibodies reacting to the high-incidence Vel antigen as well as low-incidence Yt(b) and Cw antigens. The patient's plasma was non-reactive with three of four Vel-negative (-) cells, whereas the reactive cell was Cw positive (+) and Yt(b+). Two allo-adsorptions were performed to remove anti-Vel. Upon repeat testing, anti-Cw was identified by LISS indirect antiglobulin test. Eluate from adsorbing RBCs was reactive with Vel- and Yt(b+) cells, suggesting presence of anti-Ytb. In preparation for HSCT, anti-Vel and anti-Cw were titered at 0 and 64, respectively. MMA for anti-Vel ranged at 0.2-2% (normal <3%). Nevertheless, the hospital-based Transfusion Service provided rare ABO/Rh Vel- CW- Yt(b-) crossmatch-compatible RBC to minimize the potential for stimulating anti-Vel, which might compromise a Vel+ HSCT. The patient required about 1 RBC unit per week to maintain hemoglobin above 4.5 g/dL. The Transfusion Service coordinated a search for antigen-negative RBCs with a national rare donor program, allowing at least 4 rare RBC units to be available at all times. Over an 18-month time period, the patient received 62 RBC Vel- units: 45 out of 62 (73%) were Cw- and 17 were Cw-unscreened but C-. Later in the patient's course, her transfusion rate increased to 2 RBC units per week. Because insufficient Vel- units were available within the USA, an international search by a rare donor program identified Vel- donors in Europe. FDA approval was obtained to import the rare units. She received 2 units from Spain and 2 units from Switzerland. Her leukemia progressed, and transfusion support was discontinued.ConclusionCoordination between hospital-based Transfusion Service, hematologists, and rare donor programs is required for rare RBC transfusion support in patients with antibodies against high-incidence antigens. A transfusion threshold of 4.5 g/dL may be tolerated when availability of rare RBC units is limited. DisclosuresNo relevant conflicts of interest to declare.

Transfusion Support in Patients with Sickle Cell Anemia Undergoing Haploidentical Hematopoietic Cell Transplantation

Introduction: Hematopoietic cell transplantation (HCT) is the only curative therapy for sickle cell disease (SCD), though is not widely utilized due to inadequate donor availability. Our center has previously reported improved outcomes with a reduced intensity, haploidentical bone marrow transplant (haplo-BMT) with post-transplant Cytoxan and thiotepa (de la Fuente et al, Biol Blood Marrow Transplant 2019). All patients treated with this protocol require red blood cell (RBC) support for anemia. Alloimmunization to minor RBC antigens can be a barrier to therapies including HCT, especially in those patients with multiple antibodies or those requiring rare RBC units. We report on our experience thus far in seven patients with SCA on this protocol. Materials and Methods: After IRB approval, we report in a cohort of 10 patients who completed haplo-BMT with our ongoing platform (ClinicalTrials.gov Identifier: NCT01850108). Phenotypic matching of RBCs beyond ABO and Rh(D) is necessary since patients with SCD commonly produce antibodies against minor RBC antigens, which can result in transfusion reactions such as delayed hemolysis and hyperhemolysis. Our institutional practice is to obtain minor RBC phenotyping on both the patient and their donor prior to transplant. The blood bank provides RBCs that are phenotypically matched for Rh and Kell antigens regardless of antibody status. If a patient has a history of an antibody or a positive screen, the blood bank provides extended phenotypic matching to include Fya, Fyb, Jka, Jkb, and MNS if possible. Outcomes data were analyzed using the CIBMTR database and EMR. Results: A total of 10 patients underwent haplo-BMT, 7 for sickle cell anemia and 3 for beta thalassemia major. Two patients had alloantibodies prior to haplo-BMT, both of whom had SCA. Three patients were ABO identical with their donor; five patients received minor ABO incompatible transplants, and two received major ABO incompatible transplants. Indications for transplant included transfusion dependence (5 patients), cerebrovascular accidents (4 patients), recurrent pain crises (1 patient), visual impairment (1 patient), and seizures (1 patient). The median recipient age at transplant was 17.8 years for the 8 males and 2 females included. Median donor age was 37.5 years, including 4 males and 6 females, with 7 parental donors and 3 sibling donors. No grade 1 acute graft-versus-host disease (GvHD) was noted, though 30% (3/10) had grades II-IV disease. Limited chronic GvHD occurred in 20% (2/10) patients, without any cases of extensive disease. A median of 3.5 RBC (range 0 - 14) transfusions and a median of 10 (range 1 - 24) platelet transfusions were required from date of transplant until neutrophil engraftment. None of the patients had delayed erythroid engraftment. Conclusion: We report successful haploidentical HCT in 7 patients with sickle cell anemia. Providing appropriate phenotypically matched RBCs is especially important in the era of emerging cures for sickle cell anemia, including gene therapy and haploidentical HCT. Alloimmunization is an understudied barrier to HSCT and must be carefully assessed when planning for HCT or other curative therapies required RBC transfusion support. 1. de la Fuente J, Dhedin N, Koyama T, et al. Haploidentical Bone Marrow Transplantation with Post-Transplantation Cyclophosphamide Plus Thiotepa Improves Donor Engraftment in Patients with Sickle Cell Anemia: Results of an International Learning Collaborative. Biol Blood Marrow Transplant 2019;25:1197-1209. 2. Bolanos-Meade J, Fuchs EJ, Luznik L, et al. HLA-haploidentical bone marrow transplantation with posttransplant cyclophosphamide expands the donor pool for patients with sickle cell disease. Blood 2012;120:4285-91. Disclosures No relevant conflicts of interest to declare.

SP-11 - Transfusion support of patients following HSCT

SP-11 - Transfusion support of patients following HSCT

Shifting ground and gaps in transfusion support of patients with hematological malignancies

The transfusion support of hematological malignancies considers 2 dimensions: the quantity of what we order (in terms of triggers, doses, targets, and intervals), and the special qualities thereof (with respect to depths of matching and appropriate product modifications). Meanwhile, transfusion-related enhancements in the quantity and quality of life may not be dose dependent but rather tempered by unintended patient harms and system strains from overexposure. Evidence and guidelines concur in endorsing clinically noninferior conservative red blood cell (RBC) transfusion care strategies (eg, triggering at hemoglobin <7-8 g/dL and in single-unit doses for stable, nonbleeding inpatients). However, the unique subpopulation of patients with hematological malignancies who are increasingly managed on an outpatient basis, and striving at least as much for quality of life as quantity of life, is left on the edges of these recommendations, with more questions than answers. If a sufficiently specific future wave of evidence can satisfy the concerns (and contest the assumptions) of the remaining proponents of liberalism, and if conservatism is broadly adopted, savings may be potentially immense. These savings can then be reinvested to address other gaps and inconsistencies in RBC transfusion care, such as the best achievable degrees of prophylactic antigen matching that can minimize alloimmunization-related service delays and reactions.

How we evaluate red blood cell compatibility and transfusion support for patients with sickle cell disease undergoing hematopoietic progenitor cell transplantation.

Multiple hematopoietic progenitor cell (HPC) transplantation options for patients with sickle cell disease (SCD) are currently under investigation. Patients with SCD have a high rate of alloimmunization to red blood cell antigens, often complicating transfusion support. Transfusion reactions, including acute and delayed hemolytic reactions, have been observed despite immunosuppressive regimens. Allogeneic donor transplants have been shown to carry a risk of prolonged reticulocytopenia and acute hemolysis with severe anemia in nonmyeloablative regimens. We discuss our experience providing transfusion support to patients with SCD undergoing HPC transplantation, propose an outline for a complete pretransplantation evaluation, and discuss donor/recipient compatibility issues and their implications.

Packed Red Blood Cells and Platelet Transfusion Support in Patients Undergoing Bone Marrow Transplantation: Analysis of 82 Cases.

Packed Red Blood Cells and Platelet Transfusion Support in Patients Undergoing Bone Marrow Transplantation: Analysis of 82 Cases.

Guidelines for the diagnosis and management of adult aplastic anaemia.

Sally B. Killick (Writing Group Chair), Nick Bown, Jamie Cavenagh, Inderjeet Dokal, Theodora Foukaneli, Peter Hillmen, Robin Ireland, Austin Kulasekararaj, Ghulam Mufti, John A Snowden, Sujith Samarasinghe, Anna Wood (BCSH Task Force Member), Judith C.W. Marsh on behalf of the British Society for Standards in Haematology. The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust, Bournemouth, Northern Genetics Service, Newcastle upon Tyne, St Bartholomew’s Hospital, Barts Health NHS Trust, London, Barts and The London School of Medicine and Dentistry, Queen Mary University of London and Barts Health NHS Trust, London, Addenbrooks Hospital, University of Cambridge, Cambridge, Leeds Teaching Hospitals, Leeds, Kings College Hospital NHS Foundation Trust, London, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield Great Ormond Street Hospital for Children NHS Foundation Trust, London, West Hertfordshire NHS Trust, Watford.

Transfusion support in patients with dengue fever.

Dengue fever has emerged as a global public health problem in the recent decades. The clinical spectrum of the disease ranges from dengue fever to dengue hemorrhagic fever and dengue shock syndrome. The disease is characterized by increased capillary permeability, thrombocytopenia and coagulopathy. Thrombocytopenia with hemorrhagic manifestations warrants platelet transfusions. There is lack of evidence-based guidelines for transfusion support in patients with dengue fever. This contributes to inappropriate use of blood components and blood centers constantly face the challenge of inventory management during dengue outbreaks. The current review is aimed to highlight the role of platelets and other blood components in the management of dengue. The review was performed after searching relevant published literature in PubMed, Science Direct, Google scholar and various text books and journal articles.

Immature Platelet Fraction: Coming of Age of an Underutilized Test in the Setting of Thrombotic Thrombocytopenic Purpura

Copyright: © 2014 Maitta RW, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Circulating immature platelets, also known as the immature platelet fraction (IPF), is the term that defines much larger platelets that have been recently released from the bone marrow. IPF have a greater RNA content, are measured by automated hematology analyzers equipped with a reticulocyte detection channel, and are reported as percentage of the total platelet count (%-IPF) [1]. It is well accepted that a high %-IPF is usually found in either consumptive or recovering thrombocytopenic disorders [2], while a low %-IPF is characteristic of bone marrow suppression disorders [3]. However, little was known until recently about their biology compared to mature platelets. A recent report by our group indicates that immature platelets differ from mature ones in that they have a longer lifespan, may be able to continue expanding during storage and that this expansion is significantly reduced by irradiation [4]. The latter is of major importance since it indicates that immature platelets are biosynthetically active and opens the possibility to research further these blood elements for transfusion support of patients needing platelets. Indeed in young pediatric patients who have received stem cell transplantations, a recent study reported that transfusion of IPF-rich platelet units significantly reduced the overall number of platelet transfusions required by these children compared to those receiving IPF-poor units [5]. Considering the increased longevity and distinct biology of immature platelets, these preliminary findings suggest that larger randomized trials ought to be performed to address if the concentration of immature platelets in a platelet product can further benefit patients requiring platelet transfusions.

Defining the clinical need for rare red blood cells

Transfusion support of patients with antibodies against high frequency (HF) antigens or a combination of antibodies that is rare is challenging and requires multidisciplinary cooperation.The treating physician should decide if there is a definitive clinical need for red blood cell (RBC) transfusion for the specific patient. According to recent clinical trials RBC transfusion is usually not indicated if the patient is haemodynamically stable and the haemoglobin (Hb) is higher than 7 g/dl. Alternative strategies for patient support might be required if rare blood is unavailable or while awaiting rare RBC unit arrival from national or international sources.

Fresh Whole Blood Use for Hemorrhagic Shock

Transfusion support of patients with hemorrhagic shock has changed over time with the development of storage and processing methods. Transfusion medicine developed during World War I with the use of whole blood, and now in the developed world, component therapy predominates. In contrast, there is still clinical use of fresh whole blood (FWB) in the developing world, in a minority of children's hospitals, and in combat settings. Although there is a rationale for the use of FWB in massively bleeding patients compared with the use of individual components, it has rarely been analyzed in prospective randomized clinical trials. Recent retrospective studies in adult trauma and mixed critically ill patients have revived this decades-old controversial question of the value of FWB for patients with severe shock and coagulopathy or those at risk. The risks of FWB use have also been highlighted recently, which has caused some to focus on reducing these risks with alternative processing and storage methods. It is important to recognize that current processing and storage methods for components have also not been adequately explored to determine whether they affect clinical outcomes. In this article, we review potential benefits and risks of FWB use for patients with hemorrhagic shock from any cause, and how current and future processing and storage methods may affect efficacy and safety of FWB in this population. We intend this review to stimulate hypothesis generation and clinical investigation in determining when FWB may be indicated and how to optimally process and store FWB to maximize its risk-benefit ratio.

Improving blood safety and patient outcomes with pathogen reduction technology

International Congress of Clinical Transfusiology, Polish National Transfusion Service September 24th 2010, Hotel Ossa, Ossa, Poland This symposiumwas a part of the International Congress of Clinical Transfusiology, which took place in September 2010 in Ossa, Poland. An overview of the Mirasol Pathogen Reduction Technology (PRT) and the results from its use in research and clinical settings were presented. Among presenters were research scientists and doctors who used PRT treated blood components in the research laboratories and routinely for the transfusion support of patients.

Detection of IgG anti-A/B must be essential for safe transfusion support in patients undergoing ABO incompatible allogeneic HSCT

Recipients of ABO incompatible allogeneic HSCT present with unusual ABO groups and crossmatch problems accompanied by change of the ABO group from that of the host to the donor. We report on a patient undergoing major ABO incompatible allogeneic HSCT (donor/recipient: A/O) whose blood group was wrongly established to have completely switched to blood group A when using a routine tube method and micro gel column blood grouping card on the 68th day post transplantation. The major crossmatch test with added antiglobulin and blood group A red cells was still positive. After further investigation, an explanation was found because we could not detect IgG anti-A in the serum. At the same time, anti-A coated the patient’s RBCs and could be identified using a heat elution method although the DAT was negative. We also found an obvious mixed field with the LISS-IAT gel card. Hence, routine methods of ABO grouping are unfit for ABO incompatible allogeneic HSCT patients and a micro column neutral gel card is recommended for forward typing especially to detect mixed fields and a LISS-IAT gel card or IAT tube method for detecting IgG anti-A/B in reverse typing.

Red blood cells transfusions in oncological patients treated with radio- and chemoterapy

Anemia is one of the most frequent hematology disorders in patients with malignant diseases. It has a great influence on reduction of the quality of life, so it requires early diagnosis and an adequate treatment. The aim of this study was to present and analyze the treatment of anemia using red blood cell transfusions in patients with malignancies, to analyze adequate use of red blood cell transfusions according to hemoglobin concentration, and also the influence of the treatment of malignant disease on the level of anemia and use of red blood cells transfusion. This retrospective analysis included the data on the use of red blood cells in Oncological Clinic of Clinical Center Nis in a period from the 1st January 2008 to the 31st December 2008. None of the patients received the whole blood. In this period, 735 patients received 1006 units of red blood cells (red blood cell concentrate, resuspended, washed, filtered). An average use of red blood cell transfusion was 1.37 unit per oncological patient who received transfusion. The use of red blood cell units was adequate (87.60% of patients received transfusion of red cells when Hgb < 80 g/L). During radio- and chemotherapy we noticed a decrease of hematological parameter values. The patients of the experimental group were dependant on red blood cells transfusion. Statistically, a significant decrease of hemoglobin level was observed in patients treated only with radiotherapy who are the greatest consumers of red blood cells. Two patients were registered who more likely to have febrile nonhemolytic transfusion reactions. Posttransfusion alloimmunization occurred in 0.68% of the patients. The use of red blood cells in oncological patients is in compliance with the up to date tendencies and recommendations published in clinical guidelines. For the purpose of efficient transfusion support in patients with malignant diseases, we have to follow the newest knowledge and attitudes about clinical use of blood products.