Anaemia

Symptomatic anaemia is common both at initial diagnosis and, later on, as a complication of chemotherapy (due to bone marrow suppression). Particularly where the diagnosis of leukaemia is yet to be formally made, consider whether haematinic deficiency may be the cause of the patient’s presentation, as an alternative diagnosis to leukaemia.

If severely symptomatic, then red cell transfusion should be considered. At presentation, this can be managed in the normal way. Later down the line, once patients have received treatments such as chemotherapy and bone marrow transplant, irradiated blood may be required¹⁵ – if in doubt it is safer to be cautious and use such products, but if time allows then advice could be sought from a haematologist. CMV negative blood is never required for these patients¹⁶.