Transfusion in Benign Haematological Disease

Benign haematological disorders frequently create problems for the blood bank, be they serological/testing challenges or obstacles to transfusion therapy. This chapter aims to provide a practical overview of common, non-malignant haematological disorders relevant to transfusion practice. For each entity/disorder, it reviews pathophysiology, approaches to transfusion therapy and possible alternative treatments. The chapter also focuses on benign red blood cell and platelet (PLT) disorders, with a particular emphasis on acquired immunological and functional diseases. Congenital disorders of haemoglobin are covered elsewhere, as are congenital/acquired (non-PLT-related) bleeding problems. For functional defects, PLT transfusion is a reasonable option for treating bleeding, or for procedural prophylaxis. Approaches for overcoming immune-mediated PLT destruction include watchful waiting (often done in children), immunosuppressive medications and ceasing any offending medications. In general, PLT transfusion is not indicated in patients responsive to medical management without evidence of significant/life-threatening bleeding.