Conclusions


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A hemoglobin level of 7 g/dL is a suitable indication for red blood cell transfusion in stable patients with­out complications. However, patients with cardiovas­cular disease or acute coronary syndrome should be transfused at a hemoglobin level of 8 g/dL. Indications for transfusion in patients with other types of com­plications have not been established. Patients with cancer have reported an increased feeling of wellbeing and stamina when maintained at hemoglobin levels at about 7 g/dL, but no structured studies have de­termined the optimal hemoglobin levels for patients with advanced cancer.

Although coagulopathy is uncommon in patients with cancer, fresh frozen plasma is used as replace­ment therapy for moderate to severe coagulopathy. Fresh frozen plasma may also be used for increases in the international normalized ratio in preparation for invasive procedures, although no structured studies have established the exact value.


From the Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, Minnesota. 

Address correspondence to Jeffrey McCullough, MD, Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Mayo Mail Code 609, 420 Delaware Street South East, Minneapolis, MN 55455. E-mail: [email protected] 

Submitted June 26, 2014; accepted October 31, 2014. 

No significant relationships exist between the authors and the companies/organizations whose products or services may be referenced in this article. 


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