Background: Patients with cancer often develop significant anemia, whi
ch traditionally has been successfully managed by transfusion. Althoug
h substantially safer than in the past, transfusions continue to carry
a variety of risks. The recent licensing of erythropoietin now provid
es a second treatment option, which indicates a need to reassess the u
se of transfusion to manage anemia in these patients. Study Design and
Methods: A 12-month retrospective chart review of all patients receiv
ing outpatient transfusions at a large institution was used to identif
y patients with solid tumors (including lymphoma) requiring transfusio
ns for any cause. Transfusions were considered as aberrations if they
necessitated unusual laboratory monitoring or resulted in clinical evi
dence of a transfusion reaction. Patient charges proximately related t
o the transfusion were calculated. Results: A total of 219 patients re
quiring transfusions were identified, with 483 transfusion episodes an
d the use of 812 units of red cells to manage anemia (mean, 3.71 units
/patient). A total of 100 aberrations were recorded, Twenty-two (10%)
of 219 patients had a positive antibody screen that required further w
ork-up; transfusion reactions occurred in 19 patients (8.7%). Conclusi
on: Careful assessment by hematologists and oncologists of the risk:be
nefit ratio of erythropoietin and transfusion in patients with cancer
is urged.