Key points
- Transfusion threshold in a stable inpatient: 7 g/dL; 8 with cardiovascular disease or orthopaedic surgery [1].
- An erythropoiesis-stimulating agent for chemotherapy-induced anaemia with haemoglobin below 10, when treatment is not curative [2].
- Before an erythropoiesis-stimulating agent: rule out other causes (iron, B12 or folate deficiency, bleeding, haemolysis) [2].
Blood transfusion
In stable inpatients, including haematology and oncology patients, the AABB guideline recommends a restrictive threshold of 7 g/dL [1]. Give one unit at a time and reassess; take symptoms (dyspnoea, tachycardia, chest pain) into account too.
Erythropoiesis-stimulating agents
- Indication: chemotherapy-induced anaemia with haemoglobin below 10 g/dL when the aim of treatment is not curative; also in lower-risk MDS [2].
- Target: the lowest haemoglobin that avoids transfusion; if there is no response after 6 to 8 weeks, stop [2].
- Risks: more venous thrombosis; caution in patients with a history of thrombosis [2].
- Iron: IV iron with an erythropoiesis-stimulating agent improves the response in absolute or functional iron deficiency [2].
References
2 referencesShow all referencesClose the reference list
Numbers in the text, such as [1], refer to these sources. Sources with a “Study card” button are summarised in the site’s evidence library.
- 1
- 2
This page is based on reputable scientific sources and was last updated on 28 October 2026. The content of this website is for educational and informational purposes only and does not replace consultation, diagnosis or treatment by a specialist physician. Consult your treating physician about any treatment decision.
Printed from the website; the full and up-to-date version: https://drdabiri.com/en/learn/cancer-anemia-transfusion-esa/