Limp And Pale Body In Patients With Leukemia During Blood Transfusions?

Good evening Doctor, Doctor, I want to ask. My family is currently in the hospital, he has leukemia, for several days I want to do a blood transfusion but his body has refused, for some reason. now the patient’s condition is weak and pale. My question is, why can the patient’s body refuse a blood transfusion that would be done and ask for help what we should immediately do. Thank you, doctor

1 Answer:

Hello Katili Mow,

Anemia or low blood hemoglobin levels are often found in leukemia patients. Anemia in leukemia patients can occur due to disorders of the spinal cord due to the disease process or due to side effects of chemotherapy.

Hemoglobin level below 7 mg / dl is an indication for blood transfusion (generally Packed Red Cell). There are many types of blood / blood components available to be transfused to patients, the indication of administration also varies. Leukemia patients in the period of treatment almost always require blood transfusions.

Transfusion reactions are reactions that occur following a transfusion of blood products. Transfusion reactions can be acute (within 24 hours after the transfusion) or delayed (interval of several days). Transfusion reactions can occur due to the immunological response of the recipient's blood body where the body's antibodies will either recognize or over-respond to antigens in the donor's blood; and it could also be due to incompatibility of the ABO group of blood given. Transfusion reactions can also be non-immunological, that is, due to bacterial contamination of donor blood components.

The form of transfusion reactions can vary from mild to severe, which causes anaphylactic reactions, acute blood hemolysis, and acute pulmonary injury related to blood transfusion.

The symptoms that need to be suspected as a transfusion reaction are:

 Significant increase in heart rate post transfusion Sudden increase in body temperature Shivering All over the body with or without rashes and hives Nausea Coughing or shortness of breath Decreased urine volume or color of urine becomes concentrated Decreased blood pressure When suspected transfusion reaction, transfused being given must be stopped immediately then the transfusion route is replaced with a normal saline infusion. Evaluation and confirmation of blood types in the laboratory section - blood banks need to be carried out on blood bags given to patients. Patients need to be observed vital signs every 15 minutes, and given supportive drugs to overcome allergic reactions such as antihistamines and antipyretics (fever-reducing).

Repeated transfusion in patients with leukemia can also cause iron buildup, especially in the liver and spleen, so that iron chelation therapy is needed.

Handling that can be done needs to be adjusted to the patient's current condition. The doctor may be able to ask the laboratory for blood banks to cross-check blood components given to patients, administering blood with other types of blood components or blood-administering measures given to patients. Thus the explanation from me, hopefully useful.

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