Most people don’t think much about the state of their local blood supply, but it’s often top of mind for people who have cancer. An ongoing shortage of donated blood is prompting blood donation organizations to put out the call for blood donors.
"The person most likely to become a regular blood donor is someone who has had a loved one need blood as part of their care," said Sandhya Panch, MD, MPH, medical director of transfusion at Fred Hutch Cancer Center and an associate professor of hematology at University of Washington School of Medicine.
In this conversation with Panch, we take a look at how blood supply shortages affect people with cancer, the different types of blood donations and how you can help:
Why is there a shortage of donated blood?
There are a lot of reasons, beginning with the fact that just 3% of Americans donate blood regularly. We have had to ration the amount of blood products we’re giving to patients. For some patients, this directly impacts their care and for some, not so much. More recently, we have experienced some supply chain issues from donation centers.
How to prepare for a successful donation experience
Prepare physically: Stay hydrated by drinking extra water and eating iron-rich foods (e.g., spinach, red meat, lentils) in the days leading up to donation.
Manage anxiety: If nervous about needles, let staff know they can help make the experience stress-free.
Post-donation care: Relax, eat snacks, and continue to hydrate to help the body recover quickly.
There just weren't enough donors. Unlike other products, you can’t easily just bring in certain blood products across state lines; there are regulations around these sorts of transportation logistics. Typically we rely pretty heavily on our local supply.
Sometimes we need to ration platelets to ensure the patients who are experiencing more severe internal bleeding can receive them. That can mean that we have to decide to give half-units of platelets to some patients with low blood counts but no active bleeding and reserve full units for patients who need them the most.
Can you explain blood types?
There are four blood types: A, B, AB and O. O is the most common blood type across all races; it accounts for 30% of the population. Genetics typically determines a person's blood type.
How much blood does Fred Hutch go through each month?
On average, our patients with cancer use 650 units of red blood cells and 500 units of platelets each month. Each year, about 29,000 units of red blood cells are needed every single day in the U.S. for surgeries, trauma care and treating people with chronic illnesses.
What are the different kinds of blood donations?
For the most part, blood donors contribute red blood cells and platelets.
What are blood platelets?
Platelets are blood cells that help blood clot. People with cancer can have low platelet counts. Platelet donation for people with cancer has dramatically decreased deaths due to bleeding.
Why do people with cancer need platelets?
Cancer treatment and the disease itself can destroy bone marrow, which produces blood cells. People with cancer need platelets and red blood cells and occasionally white blood cells, which are more difficult to collect, to restore their blood count to healthy levels or to fight infections. Cancer care accounts for approximately 25% of the total blood usage in the U.S.
Patients with cancers like leukemia or those undergoing intense treatments, such as bone marrow transplants, may require significant blood and platelet transfusions, with some procedures needing support from dozens of donors. For example, a single bone marrow transplant patient may need platelets from more than 100 people and red blood cells from 20 people. Patients receiving chemotherapy, radiation, and surgery for cancer may require weekly transfusions.
A lot of cancer cells originate in the bone marrow and prevent the production of normal cells so you can develop profound anemia or low platelet count, which results in decreased ability to prevent bleeding.
In addition, certain types of cancer can impact your spleen or liver. These organs grow in size and chew up normal cells. So it’s not just a production problem, but a destruction problem.
When cancer patients receive chemotherapy and radiation, their bone marrow cells may be damaged, requiring red blood cell and platelet transfusions.
Does Fred Hutch collect blood?
Fred Hutch does not accept blood donations directly. Bloodworks Northwest is our local community blood donation center. Fred Hutch gets up to 80% of our blood products there. Bloodworks Northwest is among the few blood centers that collect white blood cells from donors, too, depending on patients’ needs.
Is the same process used to collect blood cells and platelets?
The processes are similar. Collecting red blood cells is easier. It involves a needle stick and takes about 20 minutes, then you go to the break room and hydrate. Platelets are collected via apheresis, a process by which you collect blood through a vein in one arm and return everything but the platelets back to the patient. This takes about three hours. You can watch a movie or read a book to pass the time.
Donating blood makes some people feel woozy. Are some types of blood-product donations easier to tolerate than others?
Donating platelets can be a good option because it doesn’t take out as much volume as whole blood donation does. You can ask your local blood center about donation options. Even with red blood cell donations, hydrating well before and after can minimize dizziness or lightheadedness.
How can community members help?
Find out how to become a donor by visiting the Bloodworks Northwest website.
To boost the local blood supply, people can donate regularly if eligible, organize or sponsor local blood drives through schools and workplaces, and spread awareness via social media. Try sharing personal donation videos on social media, which can encourage friends to overcome their fear of needles.
Editor's note: This article originally published June 16, 2022 and has been updated.
