Not to sound ingorant but can someone tell me why AML patients need so many blood transfusions? Where does the blood go? What happens to it? If there is no bleeding happening anywhere, then where does it go? Any insight anyone could provide would be awesome!
~ peace and love ~
Even if there is no bleeding..we need to have blood transfusions as in Leukemia, body can not make healthy blood cells on its own.
To put in lay man's terms, our bone marrow is a big production factory..manufacturing different type of blood cells..which then convert to White blood cells/Red blood cells or Plateletes based on their characteristics. This is a continous manufacturing process..old cells complete their life cycle & new cells are manufactured. Different type of blood cells have different life cycle...ranging from 1-2 days to 7 days.
In case of AML..bone marrow is affected & instead of mature white blood cells, it makes immature blood cells known as blasts..which multiply very fast & have no definite life cycle..hence remain in the blood stream thereby clogging it & hampering the normal production of blood cells - RBC's/ Platelets also..
This is very basic explanation. Hope your doubt is cleared.
The chemotherapy temporarily injures the bone marrow and for a little while after each round of chemo the bone marrow's production of new blood cells slows down considerably. The bone marrow does recover again and starts producing new blood cells again, but until that recovery happens any blood cells that reach the end of their natural lifespan and die are not being replaced by new blood cells so consequently the patients blood counts start steadily dropping . The transfusions are given to keep "top up" the patients own blood until the bone marrow recovers and starts pumping out new blood cells again.
Good explanations, and personally, when I was in active treatment, I loved getting a blood transfusion---I felt better almost instantly, my skin got pink instead of grey, I had more energy and wasn't hearing that eerie sound of my heart pounding in my head. Amazing what a transfusion can do when you are low, and until you start being able to generate new cells on your own. Platelet transfusions are very necessary and help in other ways (obviously you feel better because you know you aren't going to bleed uncontrollably) but it's the blood that makes you feel noticeably better.
I know that sound in your ear when you need a transfusion. It was always an indication that I needed to get back to the hospital as soon as I could for a transfusion. It has been 12 years this June since I was diagnosed with AML. I had many transfusions over a 6 months period. Nearly bleed out a time or two. Had break-through bleeding in my lungs and wound up on a ventilator for awhile. Wow, I just never knew a body could be so sick and survice. But mine did.
I remember having to be admitted on Halloween. I felt like a vampire hunting blood.
The thing I'd emphasize is that all blood cells have a lifespan. They develop in the marrow, do their work in the bloodstream and then die and are sloughed out of the body. I'm not sure how that last bit happens, but there's some mechanism.
Hope that answers your question: Where do they go?
It's also not simply that the chemo damages the marrow, the marrow was damaged to begin with. I was checked into the hospital because my endocrinologist decided I needed some RBC, my HGB was down to 5.5. It was when the onc came in the next day that they discovered I had AML. So, in essence, even though we didn't know what was wrong at the time, my first treatment was blood product.
Tex is quite right, sometimes blood transfusions are necessary even before the administration of any chemo. My son had to have 2 transfusions (1 of platelets and 1 of plasma) before going into surgery for the insertion of the central line. The other 29 transfusions he had were after chemo.
"They develop in the marrow, do their work in the bloodstream and then die and are sloughed out of the body. I'm not sure how that last bit happens, but there's some mechanism."
The dead red blood cells are carried to the spleen. The heme and globin portions are split apart. The globin is broken down into its amino acid components to be used for other proteins. The iron is removed from the heme portion where it is eventually transported back to the red bone marrow to be incorporated into new RBCs. The non-iron portion of heme goes through a series of chemical conversions that eventually end up as stercobilin in the large intestine which is what gives feces its characteristic brown color
I agree that receiving a blood transfusion makes you feel tons better! More energy, more color, and it doesn't hurt when you get it.
My question is, do we actually lose volume of blood? I had a terrible "swooshing" sound in my ears that was driving me crazy. I could hear
it when my heart would beat. I've not had that again since my counts are higher.
Yes, Teri---I know exactly the sound you are talking about. In fact, my oncologist would usually give me blood, not so much based on my hemoglobin numbers but on my complaints about feeling tired and hearing that sound in my head!
I, too, had two units of blood transfused before I was ever diagnosed with AML. The BMB and my eventual diagnosis didn't occur until the next day. But I was so anemic, I needed blood right away. I'm sure my doctor was reasonably sure I had some kind of leukemia anyway...
Well I just thought I would add that due to the reason that so many leukemia patients need so Many blood transfusion and platelets, and of course in honor of my mother, I begin Thursday donating blood regularly. I will also be giving platelets and even though I am scared as heck about being hooked up to that machine I know I can do it just like you all do everyday! hugs, nicole
Thanks, Pam, and thank your friend, too. I was completely ignorant about platelets before all this, and I would think lots of other folks are, too. I was just wondering about how much different the donation procedure was for platelets vs. whole blood. I had lots of folks who wanted to help me out, and blood product donations were something lots of them could do. The nice thing was, even if it didn't help me directly, it helped some one else.
Well, we really don't get hooked up to a pheresis machine every day. I've never been on one.
As mentioned a moment ago, my wife gave PLT regularly (she hasn't since we moved to CO and I can't really bug her about it). The machine didn't bother her. I think you might want to see if they have video or buy a cheap portable DVD player...or bring a good book. The worst thing I got from her about it is it's pretty boring.
Good job, you.