ABSTRACT
Your primary aim in transfusing the pediatric oncology patient is to provide marrow support to ensure adequate tissue oxygenation and prevent bleeding. As such, red blood cells and platelets will be the blood products you use; plasma and cryoprecipitate have no role in this setting unless the child becomes critically ill and coagulopathic. Likewise, I do not discuss granulocyte transfusions here, other than to mention that their use is somewhat controversial and their efficacy inconsistent. Your secondary aims are achieved with modifications to RBCs and platelets as cellular blood products and are threefold: to prevent transfusion-associated graft-versus-host disease with irradiation, to minimize H LA alloimmunization with leukoreduction, and to mitigate the risk o f CM V transmission in the unexposed patient with either seronegative or leukoreduced units.
